DAVID GUSTAD DEVITRE DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

GUSTAD

Last Name

DEVITRE

Suffix

Business Name

DAVID GUSTAD DEVITRE DO

Original Issue Date

01/29/2008

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017