GREGORY L FIETS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

NOT RENEWED

Business

First Name

GREGORY L

Last Name

FIETS

Suffix

Business Name

GREGORY L FIETS MD

Original Issue Date

12/12/1995

Effective Date

12/12/1995

Expiration Date

07/31/2008

City

CARBONDALE

State

Zip

62902

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008