MARC RICHARD UDALL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

NOT RENEWED

Business

Title

First Name

MARC

Middle

RICHARD

Last Name

UDALL

Business Name

MARC RICHARD UDALL MD

Original Issue Date

04/24/2014

Effective Date

04/24/2014

Expiration Date

07/31/2017

City

NAUVOO

State

Zip

62354

County

HANCOCK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017