ANTHONY O AMIEWALAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

ACTIVE

Business

First Name

ANTHONY

Middle

Last Name

AMIEWALAN

Suffix

Business Name

ANTHONY O AMIEWALAN MD

Original Issue Date

08/17/2004

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

DECATUR

State

Zip

62521

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023