ALAN J BIRTWISTLE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

ALAN

Middle

Last Name

BIRTWISTLE

Suffix

Business Name

ALAN J BIRTWISTLE MD

Original Issue Date

12/18/2003

Effective Date

07/21/2011

Expiration Date

07/31/2014

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014