GINA MARIE MATHEW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

NOT RENEWED

Business

Title

First Name

GINA

Middle

MARIE

Last Name

MATHEW

Business Name

GINA MARIE MATHEW MD

Original Issue Date

08/12/2014

Effective Date

08/12/2014

Expiration Date

07/31/2017

City

MESA

State

Zip

85213

County

ARIZONA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017