HEATHER DIANNE HARTZELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

HEATHER

Middle

DIANNE

Last Name

HARTZELL

Suffix

Business Name

HEATHER DIANNE HARTZELL MD

Original Issue Date

06/21/2000

Effective Date

06/21/2000

Expiration Date

07/31/2002

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006