MAOXIIM TELLEZ MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

ACTIVE

Business

Title

First Name

MAOXIIM

Last Name

TELLEZ

Business Name

MAOXIIM TELLEZ MD

Original Issue Date

05/10/2007

Effective Date

04/19/2023

Expiration Date

07/31/2026

City

PETERSBURG

State

Zip

62675

County

MENARD

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/19/2023