CARRIE ANN MUDD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

CARRIE

Middle

ANN

Last Name

MUDD

Suffix

Business Name

CARRIE ANN MUDD MD

Original Issue Date

04/12/2011

Effective Date

07/17/2017

Expiration Date

09/30/2020

City

WATERLOO

State

Zip

62298

County

MONROE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021