TIM C KISABETH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

First Name

TIM C

Last Name

KISABETH

Suffix

Business Name

TIM C KISABETH MD

Original Issue Date

08/06/2014

Effective Date

06/05/2017

Expiration Date

09/30/2020

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021