JEFFERSON G ISH Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****50

License Status

NOT RENEWED

Business

First Name

JEFFERSON G

Last Name

ISH

Business Name

JEFFERSON G ISH

Original Issue Date

01/01/1998

Expiration Date

01/31/1985

City

ROCKFORD

State

Zip

61107

County

BOONE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2006