GREGORY THOMAS BISMACK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

ACTIVE

Business

Title

First Name

GREGORY

Middle

THOMAS

Last Name

BISMACK

Business Name

GREGORY THOMAS BISMACK MD

Original Issue Date

03/12/2021

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63112

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023