THAYER S PHELAN 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

THAYER

Middle

Last Name

PHELAN

Business Name

THAYER S PHELAN MD

Original Issue Date

08/08/2019

Effective Date

08/23/2023

Expiration Date

07/31/2026

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/23/2023