ALYSSA NICOLE HUMPHREY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

ACTIVE

Business

Title

First Name

ALYSSA

Middle

NICOLE

Last Name

HUMPHREY

Business Name

ALYSSA NICOLE HUMPHREY MD

Original Issue Date

09/16/2016

Effective Date

07/22/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/22/2023