CARTER PAGE FENTON JR DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

First Name

CARTER

Middle

PAGE

Last Name

FENTON

Suffix

JR DO

Business Name

CARTER PAGE FENTON JR DO

Original Issue Date

01/18/2017

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

CHESTERFIELD

State

Zip

63017

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021