MARTIN RUSSELL O'MALLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

Title

First Name

MARTIN

Middle

RUSSELL

Last Name

O'MALLEY

Business Name

MARTIN RUSSELL O'MALLEY MD

Original Issue Date

03/24/2015

Effective Date

05/08/2017

Expiration Date

09/30/2020

City

SILVIS

State

Zip

61282

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021