LILLIAN RAE HARSTINE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

Title

First Name

LILLIAN

Middle

RAE

Last Name

HARSTINE

Business Name

LILLIAN RAE HARSTINE MD

Original Issue Date

02/06/2019

Effective Date

02/06/2019

Expiration Date

09/30/2020

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021