MIRIAM DANESE SLATTER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

NOT RENEWED

Business

Title

First Name

MIRIAM

Middle

DANESE

Last Name

SLATTER

Business Name

MIRIAM DANESE SLATTER MD

Original Issue Date

02/11/2015

Effective Date

02/11/2015

Expiration Date

07/31/2017

City

MARION

State

Zip

62959

County

WILLIAMSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017