TODD HARLAN PETTY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

ACTIVE

Business

First Name

TODD

Middle

HARLAN

Last Name

PETTY

Suffix

Business Name

TODD HARLAN PETTY MD

Original Issue Date

06/02/2022

Effective Date

04/21/2023

Expiration Date

07/31/2026

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/21/2023