SUSAN MARIE IRVINE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

MARIE

Last Name

IRVINE

Suffix

Business Name

SUSAN MARIE IRVINE MD

Original Issue Date

08/10/1998

Effective Date

08/10/1998

Expiration Date

07/31/2005

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006