GALEN A WEISS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

First Name

GALEN

Middle

Last Name

WEISS

Business Name

GALEN A WEISS

Original Issue Date

04/16/2007

Effective Date

05/29/2008

Expiration Date

07/31/2011

City

GLEN CARBON

State

Zip

62034

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011