KEISHA MARTINEZ POWELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

ACTIVE

Business

Title

First Name

KEISHA

Last Name

MARTINEZ POWELL

Business Name

KEISHA MARTINEZ POWELL MD

Original Issue Date

04/21/2016

Effective Date

04/05/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/14/2023