MARVIN DWIGHT MAXWELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

MARVIN DWIGHT

Last Name

MAXWELL

Suffix

Business Name

MARVIN DWIGHT MAXWELL MD

Original Issue Date

10/19/1992

Effective Date

10/19/1992

Expiration Date

07/31/1996

City

CARBONDALE

State

Zip

62901

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006