FREDERICK THANE DEWEESE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

ACTIVE

Business

First Name

FREDERICK

Middle

THANE

Last Name

DEWEESE

Suffix

Business Name

FREDERICK THANE DEWEESE MD

Original Issue Date

06/30/2015

Effective Date

07/07/2023

Expiration Date

07/31/2026

City

METROPOLIS

State

Zip

62960

County

MASSAC

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/07/2023