THOMAS D MYLES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

NOT RENEWED

Business

First Name

THOMAS D

Last Name

MYLES

Suffix

Business Name

THOMAS D MYLES MD

Original Issue Date

08/28/2003

Effective Date

08/28/2003

Expiration Date

07/31/2005

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020