MARK CARROLL EDDY 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

MARK

Middle

CARROLL

Last Name

EDDY

Suffix

Business Name

MARK CARROLL EDDY MD

Original Issue Date

07/16/1998

Effective Date

07/16/1998

Expiration Date

07/31/2002

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020