CAROLYN M MARTIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036130332

License Status

NOT RENEWED

Business

Title

First Name

CAROLYN

Middle

Last Name

MARTIN

Business Name

CAROLYN M MARTIN MD

Original Issue Date

05/11/2012

Effective Date

05/15/2017

Expiration Date

09/30/2020

City

MARYVILLE

State

Zip

62062

County

MADISON

Ever Disciplined

LastModifiedDate

01/14/2021