THENA GIDGET POTEAT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

ACTIVE

Business

First Name

THENA

Middle

GIDGET

Last Name

POTEAT

Suffix

Business Name

THENA GIDGET POTEAT MD

Original Issue Date

11/20/2018

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

CHESTER

State

Zip

62233

County

RANDOLPH

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/24/2023