ROBERT LEE BROGHAMMER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

LEE

Last Name

BROGHAMMER

Suffix

Business Name

ROBERT LEE BROGHAMMER MD

Original Issue Date

09/25/2003

Effective Date

09/25/2003

Expiration Date

07/31/2008

City

DECATUR

State

Zip

62526

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008