KIMYSTIAN HARRISON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

ACTIVE

Business

Title

First Name

KIMYSTIAN

Last Name

HARRISON

Business Name

KIMYSTIAN HARRISON MD

Original Issue Date

09/12/2024

Effective Date

09/12/2024

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63110

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/12/2024