FREDERICK THANE DEWEESE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

FREDERICK

Middle

THANE

Last Name

DEWEESE

Suffix

Business Name

FREDERICK THANE DEWEESE MD

Original Issue Date

08/27/2001

Effective Date

08/27/2001

Expiration Date

07/31/2005

City

METROPOLIS

State

Zip

62960

County

MASSAC

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020