MICHAEL PAUL VANANTWERP 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

MICHAEL

Middle

PAUL

Last Name

VANANTWERP

Business Name

MICHAEL PAUL VANANTWERP MD

Original Issue Date

01/03/2022

Effective Date

05/17/2023

Expiration Date

07/31/2026

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/17/2023