JAN AXELBAUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

NOT RENEWED

Business

Title

First Name

JAN

Last Name

AXELBAUM

Business Name

JAN AXELBAUM MD

Original Issue Date

06/25/2015

Effective Date

06/26/2017

Expiration Date

09/30/2020

City

SAINT LOUIS

State

Zip

63130

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021