LAURENCE IRWIN MILLER DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

First Name

LAURENCE

Middle

IRWIN

Last Name

MILLER

Suffix

Business Name

LAURENCE IRWIN MILLER DO

Original Issue Date

12/16/1999

Effective Date

07/17/2014

Expiration Date

07/31/2017

City

QUINCY

State

Zip

62301

County

ADAMS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017