STEPHEN WILLIAM GOTH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

ACTIVE

Business

Title

First Name

STEPHEN

Middle

WILLIAM

Last Name

GOTH

Business Name

STEPHEN WILLIAM GOTH MD

Original Issue Date

05/14/2019

Effective Date

05/01/2023

Expiration Date

07/31/2026

City

EAST PEORIA

State

Zip

61611

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/01/2023