TRACY A MIZEUR Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

ACTIVE

Business

First Name

TRACY

Middle

Last Name

MIZEUR

Business Name

TRACY A MIZEUR

Original Issue Date

07/14/2005

Effective Date

06/15/2023

Expiration Date

07/31/2026

City

SHERMAN

State

Zip

62684

County

LOGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/15/2023