DOUGLAS STEWART FITZWATER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

Title

First Name

DOUGLAS

Middle

STEWART

Last Name

FITZWATER

Business Name

DOUGLAS STEWART FITZWATER MD

Original Issue Date

07/25/2018

Effective Date

07/25/2018

Expiration Date

09/30/2020

City

SHILOH

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021