WAYNE R TILSON 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

First Name

WAYNE R

Last Name

TILSON

Suffix

Business Name

WAYNE R TILSON MD

Original Issue Date

06/03/1987

Effective Date

06/03/1987

Expiration Date

07/31/1993

City

DECATUR

State

Zip

62525

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006