DAVID LEE RIESENBERGER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

First Name

DAVID LEE

Last Name

RIESENBERGER

Suffix

Business Name

DAVID LEE RIESENBERGER MD

Original Issue Date

01/01/1997

Effective Date

08/31/2020

Expiration Date

07/31/2023

City

MODESTO

State

Zip

62667

County

MACOUPIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023