AMY L ZACHARIAS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

AMY

Middle

Last Name

ZACHARIAS

Business Name

AMY L ZACHARIAS

Original Issue Date

10/01/2004

Effective Date

10/01/2004

Expiration Date

07/31/2008

City

ROANOKE

State

Zip

61561

County

WOODFORD

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020