MIRANDA ELIZABETH BLEVINS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

ACTIVE

Business

Title

First Name

MIRANDA

Middle

ELIZABETH

Last Name

BLEVINS

Business Name

MIRANDA ELIZABETH BLEVINS MD

Original Issue Date

10/23/2019

Effective Date

07/15/2023

Expiration Date

07/31/2026

City

URBANA

State

Zip

61801

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/15/2023