ANDREW JAMES MARTIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

Title

First Name

ANDREW

Middle

JAMES

Last Name

MARTIN

Business Name

ANDREW JAMES MARTIN MD

Original Issue Date

06/05/2019

Effective Date

06/05/2019

Expiration Date

09/30/2020

City

CARBONDALE

State

Zip

62901

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021