ANDREA M HUMPHREY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

ACTIVE

Business

First Name

ANDREA

Middle

Last Name

HUMPHREY

Suffix

Business Name

ANDREA M HUMPHREY MD

Original Issue Date

07/26/2007

Effective Date

07/15/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/15/2023