DAVID W BURNSIDE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

ACTIVE

Business

First Name

DAVID W

Last Name

BURNSIDE

Suffix

Business Name

DAVID W BURNSIDE MD

Original Issue Date

07/07/1995

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023