CHRISTINA MICHELLE DOHERTY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

CANCELLED

Business

First Name

CHRISTINA

Middle

MICHELLE

Last Name

DOHERTY

Suffix

Business Name

CHRISTINA MICHELLE DOHERTY MD

Original Issue Date

04/03/2007

Effective Date

06/12/2008

Expiration Date

07/31/2011

City

BELLEVILLE

State

Zip

62223

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011