AMY LYNN DOHERTY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

AMY

Middle

LYNN

Last Name

DOHERTY

Business Name

AMY LYNN DOHERTY

Original Issue Date

05/11/2015

Effective Date

05/11/2015

Expiration Date

07/31/2017

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017