MACKENZIE CAPSHAW ASEL Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

NOT RENEWED

Business

First Name

MACKENZIE

Middle

CAPSHAW

Last Name

ASEL

Business Name

MACKENZIE CAPSHAW ASEL

Original Issue Date

04/11/2018

Effective Date

04/11/2018

Expiration Date

09/30/2020

City

COLUMBIA

State

Zip

65203

County

BOONE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021