KATHLEEN SUE WITTICH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

CANCELLED

Business

First Name

KATHLEEN

Middle

SUE

Last Name

WITTICH

Suffix

Business Name

KATHLEEN SUE WITTICH MD

Original Issue Date

05/22/2002

Effective Date

05/22/2002

Expiration Date

07/31/2008

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008