MARK S FEDDER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

ACTIVE

Business

First Name

MARK S

Last Name

FEDDER

Suffix

Business Name

MARK S FEDDER MD

Original Issue Date

11/16/1983

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023