PETER MAXWELL FORMBY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

ACTIVE

Business

Title

First Name

PETER

Middle

MAXWELL

Last Name

FORMBY

Business Name

PETER MAXWELL FORMBY MD

Original Issue Date

07/30/2022

Effective Date

06/09/2023

Expiration Date

07/31/2026

City

MURPHYSBORO

State

Zip

62966

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/09/2023