MARK EDWARD DAVIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

ACTIVE

Business

First Name

MARK EDWARD

Last Name

DAVIS

Suffix

Business Name

MARK EDWARD DAVIS MD

Original Issue Date

05/29/1996

Effective Date

05/19/2023

Expiration Date

07/31/2026

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/19/2023