MARTA THERESA SPAIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

ACTIVE

Business

Title

First Name

MARTA

Middle

THERESA

Last Name

SPAIN

Business Name

MARTA THERESA SPAIN MD

Original Issue Date

08/30/2011

Effective Date

07/29/2023

Expiration Date

07/31/2026

City

LINCOLN

State

Zip

95648

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/29/2023