LIBBY K KRISTAL 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

LIBBY K

Last Name

KRISTAL

Suffix

Business Name

LIBBY K KRISTAL MD

Original Issue Date

03/18/1983

Effective Date

07/19/2017

Expiration Date

09/30/2020

City

OTTAWA

State

Zip

61350

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021