SUSANNAH K KOCH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

ACTIVE

Business

Title

First Name

SUSANNAH

Middle

Last Name

KOCH

Prefix

Business Name

SUSANNAH K KOCH MD

Original Issue Date

07/26/2022

Effective Date

07/29/2023

Expiration Date

07/31/2026

City

SHILOH

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/29/2023