THERESA MARY GEORGE DO 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

Title

First Name

THERESA

Middle

MARY

Last Name

GEORGE

Business Name

THERESA MARY GEORGE DO

Original Issue Date

09/19/2017

Effective Date

09/19/2017

Expiration Date

09/30/2020

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021