MARY CASSEBAUM MEYERS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

CANCELLED

Business

First Name

MARY

Middle

CASSEBAUM

Last Name

MEYERS

Suffix

Business Name

MARY CASSEBAUM MEYERS MD

Original Issue Date

12/18/1998

Effective Date

12/18/1998

Expiration Date

07/31/2005

City

MC LEANSBORO

State

Zip

62859

County

HAMILTON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006