SUE DAVENPORT MILLER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

ACTIVE

Business

Title

First Name

SUE

Middle

DAVENPORT

Last Name

MILLER

Business Name

SUE DAVENPORT MILLER MD

Original Issue Date

09/18/2023

Effective Date

09/18/2023

Expiration Date

07/31/2026

City

URBANA

State

Zip

61802

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/18/2023