RILEY HALSTEAD SELBY III DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

NOT RENEWED

Business

First Name

RILEY

Middle

HALSTEAD

Last Name

SELBY

Suffix

III DO

Business Name

RILEY HALSTEAD SELBY III DO

Original Issue Date

01/01/1997

Effective Date

04/11/2014

Expiration Date

07/31/2017

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017