MYISHA ZANINE PORTER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

ACTIVE

Business

First Name

MYISHA

Middle

ZANINE

Last Name

PORTER

Suffix

Business Name

MYISHA ZANINE PORTER MD

Original Issue Date

10/10/2007

Effective Date

04/21/2023

Expiration Date

07/31/2026

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/21/2023