MICHAEL ROBERT MUSTARD 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

MICHAEL

Middle

ROBERT

Last Name

MUSTARD

Suffix

Business Name

MICHAEL ROBERT MUSTARD MD

Original Issue Date

08/07/2006

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61761

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023