DAVID KENNETH BISHOP DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

NOT RENEWED

Business

Title

First Name

DAVID

Middle

KENNETH

Last Name

BISHOP

Business Name

DAVID KENNETH BISHOP DO

Original Issue Date

07/25/2016

Effective Date

07/25/2016

Expiration Date

07/31/2017

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017