JUSTIN T FOWLER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

ACTIVE

Business

First Name

JUSTIN

Middle

Last Name

FOWLER

Suffix

Business Name

JUSTIN T FOWLER MD

Original Issue Date

11/10/2021

Effective Date

07/04/2023

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

07/04/2023