MARK LOUIS WESTPHAL 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

MARK LOUIS

Last Name

WESTPHAL

Suffix

Business Name

MARK LOUIS WESTPHAL MD

Original Issue Date

01/01/1997

Effective Date

07/13/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/13/2023