GUY ELISE CONSTANT DE GENT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

ACTIVE

Business

Title

First Name

GUY

Middle

ELISE CONSTANT

Last Name

DE GENT

Business Name

GUY ELISE CONSTANT DE GENT MD

Original Issue Date

06/10/2016

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

66314

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023