SUSAN KIM REYNOLDS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

ACTIVE

Business

Title

First Name

SUSAN

Middle

KIM

Last Name

REYNOLDS

Business Name

SUSAN KIM REYNOLDS MD

Original Issue Date

03/22/2012

Effective Date

06/04/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63109

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/04/2023