ALFRED TENNYSON MITCHELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

First Name

ALFRED

Middle

TENNYSON

Last Name

MITCHELL

Suffix

Business Name

ALFRED TENNYSON MITCHELL MD

Original Issue Date

07/08/1999

Effective Date

07/08/1999

Expiration Date

07/31/2002

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006