DAVID ALBERT BRISTOW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

DAVID ALBERT

Last Name

BRISTOW

Suffix

Business Name

DAVID ALBERT BRISTOW MD

Original Issue Date

07/16/1990

Effective Date

07/16/1990

Expiration Date

07/31/1996

City

COWDEN

State

Zip

62422

County

FAYETTE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006