AMY S LARSON Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

ACTIVE

Business

First Name

AMY

Middle

Last Name

LARSON

Business Name

AMY S LARSON

Original Issue Date

04/16/2002

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/07/2023