DONALD ROBERT FISK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

First Name

DONALD ROBERT

Last Name

FISK

Suffix

Business Name

DONALD ROBERT FISK MD

Original Issue Date

01/01/1997

Effective Date

05/06/2014

Expiration Date

07/31/2017

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017