MARTIN PAUL RICHARD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125079121

License Status

EXPIRED

Business

Title

First Name

MARTIN

Middle

PAUL

Last Name

RICHARD

Business Name

MARTIN PAUL RICHARD MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/30/2024