TIM C KISABETH MD 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

TIM C

Last Name

KISABETH

Suffix

Business Name

TIM C KISABETH MD

Original Issue Date

08/14/1986

Effective Date

06/10/2023

Expiration Date

07/31/2026

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/10/2023