LISA ANN DAVIS Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

ACTIVE

Business

First Name

LISA

Middle

ANN

Last Name

DAVIS

Business Name

LISA ANN DAVIS

Original Issue Date

10/17/2019

Effective Date

06/20/2023

Expiration Date

07/31/2026

City

SILVIS

State

Zip

61282

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/20/2023