JONGJIN ANNE MARTIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

ACTIVE

Business

First Name

JONGJIN

Middle

ANNE

Last Name

MARTIN

Suffix

Business Name

JONGJIN ANNE MARTIN MD

Original Issue Date

12/14/2015

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023