DIANE A MEGAHY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

DIANE A

Last Name

MEGAHY

Suffix

Business Name

DIANE A MEGAHY MD

Original Issue Date

04/16/2007

Effective Date

06/19/2014

Expiration Date

07/31/2017

City

MARYVILLE

State

Zip

62062

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017