KEITH R MARTIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

ACTIVE

Business

First Name

KEITH R

Last Name

MARTIN

Suffix

Business Name

KEITH R MARTIN MD

Original Issue Date

07/17/1992

Effective Date

07/23/2023

Expiration Date

07/31/2026

City

FREEPORT

State

Zip

61032

County

OGLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/23/2023