MATTHEW ALLEN POWELL 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

First Name

MATTHEW

Middle

ALLEN

Last Name

POWELL

Suffix

Business Name

MATTHEW ALLEN POWELL MD

Original Issue Date

08/26/2002

Effective Date

08/26/2002

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020