MARYANNE KATHRYN MILLER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

ACTIVE

Business

First Name

MARYANNE

Middle

KATHRYN

Last Name

MILLER

Suffix

Business Name

MARYANNE KATHRYN MILLER MD

Original Issue Date

03/24/2000

Effective Date

06/29/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/29/2023