JEREMIAH BUSOG PLACIDO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

Title

First Name

JEREMIAH

Middle

BUSOG

Last Name

PLACIDO

Business Name

JEREMIAH BUSOG PLACIDO MD

Original Issue Date

12/21/2011

Effective Date

12/21/2011

Expiration Date

07/31/2014

City

MILWAUKEE

State

Zip

53209

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020