ETHAN E REYNOLDS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

ACTIVE

Business

Title

First Name

ETHAN

Middle

Last Name

REYNOLDS

Business Name

ETHAN E REYNOLDS MD

Original Issue Date

07/14/2015

Effective Date

07/02/2023

Expiration Date

07/31/2026

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/02/2023