THOMAS M PENDERGAST MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

ACTIVE

Business

Title

First Name

THOMAS

Middle

Last Name

PENDERGAST

Business Name

THOMAS M PENDERGAST MD

Original Issue Date

02/15/2022

Effective Date

07/22/2023

Expiration Date

07/31/2026

City

PARIS

State

Zip

61944

County

EDGAR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/22/2023