G ALLEN CRIST DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

ACTIVE

Business

First Name

G ALLEN

Last Name

CRIST

Suffix

Business Name

G ALLEN CRIST DO

Original Issue Date

08/19/1985

Effective Date

06/10/2023

Expiration Date

07/31/2026

City

GALENA

State

Zip

61036

County

JO DAVIESS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/10/2023