THOMAS MICHAEL DOUGHERTY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

Title

First Name

THOMAS

Middle

MICHAEL

Last Name

DOUGHERTY

Business Name

THOMAS MICHAEL DOUGHERTY MD

Original Issue Date

08/14/2014

Effective Date

10/12/2017

Expiration Date

09/30/2020

City

SAINT LOUIS

State

Zip

63146

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021