BETH ANN FISHER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

Title

First Name

BETH

Middle

ANN

Last Name

FISHER

Business Name

BETH ANN FISHER MD

Original Issue Date

10/28/2014

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

CENTRALIA

State

Zip

62801

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021