STANLEY WAYNE KOCH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

ACTIVE

Business

First Name

STANLEY WAYNE

Last Name

KOCH

Suffix

Business Name

STANLEY WAYNE KOCH MD

Original Issue Date

07/01/1985

Effective Date

06/03/2023

Expiration Date

07/31/2026

City

MORTON

State

Zip

61550

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/03/2023