TOMMY DEAN MARTIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

First Name

TOMMY DEAN

Last Name

MARTIN

Suffix

Business Name

TOMMY DEAN MARTIN MD

Original Issue Date

01/01/1997

Effective Date

10/06/2023

Expiration Date

07/31/2026

City

CENTRALIA

State

Zip

62801

County

MARION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/06/2023