DENNIS D COSTERISAN DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

ACTIVE

Business

First Name

DENNIS D

Last Name

COSTERISAN

Suffix

Business Name

DENNIS D COSTERISAN DO

Original Issue Date

07/22/1985

Effective Date

04/25/2023

Expiration Date

07/31/2026

City

DECATUR

State

Zip

62521

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/25/2023