CRAIG DEAN KOCH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

ACTIVE

Business

Title

First Name

CRAIG

Middle

DEAN

Last Name

KOCH

Business Name

CRAIG DEAN KOCH MD

Original Issue Date

08/25/2016

Effective Date

04/10/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61704

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/10/2023