DAVID M COUNTRYMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

Title

First Name

DAVID

Middle

Last Name

COUNTRYMAN

Business Name

DAVID M COUNTRYMAN MD

Original Issue Date

05/16/1988

Effective Date

05/16/1988

Expiration Date

07/31/1990

City

SCOTT AFB

State

Zip

62225

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020