ROBERT JOHN MACMILLAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

JOHN

Last Name

MACMILLAN

Suffix

Business Name

ROBERT JOHN MACMILLAN MD

Original Issue Date

06/24/2011

Effective Date

06/24/2011

Expiration Date

07/31/2014

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Specialty/Qualifier

PRACTITIONER

Ever Disciplined

LastModifiedDate

11/17/2014