ANTONY SCOTT WOLLASTON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

ACTIVE

Business

First Name

ANTONY

Middle

SCOTT

Last Name

WOLLASTON

Suffix

Business Name

ANTONY SCOTT WOLLASTON MD

Original Issue Date

12/31/2002

Effective Date

07/25/2023

Expiration Date

07/31/2026

City

QUINCY

State

Zip

62301

County

ADAMS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/25/2023