TIMOTHY JOHN FERNSTROM DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

ACTIVE

Business

Title

First Name

TIMOTHY

Middle

JOHN

Last Name

FERNSTROM

Business Name

TIMOTHY JOHN FERNSTROM DO

Original Issue Date

02/25/2021

Effective Date

06/21/2023

Expiration Date

07/31/2026

City

TACOMA

State

Zip

98402

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/21/2023