WADE LARRY THORSTAD MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

Title

First Name

WADE

Middle

LARRY

Last Name

THORSTAD

Business Name

WADE LARRY THORSTAD MD

Original Issue Date

12/22/1997

Effective Date

06/27/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63110

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/27/2023