CHARLES W KIESER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

First Name

CHARLES W

Last Name

KIESER

Suffix

Business Name

CHARLES W KIESER MD

Original Issue Date

07/28/1982

Effective Date

07/28/1982

Expiration Date

07/31/1993

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011