MARTHA CAROLINA MANN 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

Title

First Name

MARTHA

Middle

CAROLINA

Last Name

MANN

Business Name

MARTHA CAROLINA MANN MD

Original Issue Date

01/04/2021

Effective Date

01/04/2021

Expiration Date

07/31/2023

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023