ERICK ANTOINE FALCONER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112484

License Status

NOT RENEWED

Business

First Name

ERICK

Middle

ANTOINE

Last Name

FALCONER

Suffix

Business Name

ERICK ANTOINE FALCONER MD

Original Issue Date

10/06/2004

Effective Date

04/07/2011

Expiration Date

07/31/2014

City

SAINT LOUIS

State

Zip

63122

Ever Disciplined

LastModifiedDate

12/16/2016

Case Number

2016000026

Action

Revocation

Discipline Start Date

12/16/2016

Discipline Reason

based on the disciplinary history in Arizona and providing false information on his DEA renewal application.