CHARLES GORDON BISHOP JR Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

First Name

CHARLES

Middle

GORDON

Last Name

BISHOP

Suffix

Business Name

CHARLES GORDON BISHOP JR

Original Issue Date

04/10/2002

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

GLEN CARBON

State

Zip

62034

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021