LISA A DAVIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

ACTIVE

Business

Title

First Name

LISA

Middle

Last Name

DAVIS

Business Name

LISA A DAVIS MD

Original Issue Date

06/29/2023

Effective Date

06/29/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/29/2023