GLEN DEAN PITTMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

GLEN DEAN

Last Name

PITTMAN

Suffix

Business Name

GLEN DEAN PITTMAN MD

Original Issue Date

01/01/1997

Effective Date

07/12/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021