DWAIN MONTRAVILLE ROGERS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

Title

First Name

DWAIN

Middle

MONTRAVILLE

Last Name

ROGERS

Business Name

DWAIN MONTRAVILLE ROGERS MD

Original Issue Date

04/07/2010

Effective Date

05/02/2011

Expiration Date

07/31/2014

City

DECATUR

State

Zip

62521

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014