ERIC DAVID MARTIN DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

ACTIVE

Business

Title

First Name

ERIC

Middle

DAVID

Last Name

MARTIN

Business Name

ERIC DAVID MARTIN DO

Original Issue Date

08/22/2022

Effective Date

06/12/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/12/2023