THENA GIDGET POTEAT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

First Name

THENA

Middle

GIDGET

Last Name

POTEAT

Suffix

Business Name

THENA GIDGET POTEAT MD

Original Issue Date

05/25/2004

Effective Date

07/13/2017

Expiration Date

09/30/2020

City

ST LOUIS

State

Zip

63125

County

MISSOURI

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021