STANLEY WAYNE KOCH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

STANLEY WAYNE

Last Name

KOCH

Suffix

Business Name

STANLEY WAYNE KOCH MD

Original Issue Date

06/26/1985

Effective Date

06/26/1985

Expiration Date

07/31/2002

City

MORTON

State

Zip

61550

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020