THERESE LYNN POLO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

ACTIVE

Business

First Name

THERESE

Middle

LYNN

Last Name

POLO

Suffix

Business Name

THERESE LYNN POLO MD

Original Issue Date

05/25/1999

Effective Date

07/24/2023

Expiration Date

07/31/2026

City

GILLESPIE

State

Zip

62033

County

MACOUPIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/24/2023