BLAINE M LISNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

NOT RENEWED

Business

First Name

BLAINE M

Last Name

LISNER

Suffix

Business Name

BLAINE M LISNER MD

Original Issue Date

11/08/1982

Effective Date

05/09/2014

Expiration Date

07/31/2017

City

LOUISVILLE

State

Zip

40245

County

KENTUCKY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020