MATTHEW POLET DATZMAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

ACTIVE

Business

First Name

MATTHEW

Middle

POLET

Last Name

DATZMAN

Suffix

Business Name

MATTHEW POLET DATZMAN MD

Original Issue Date

03/17/2000

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

MOUNT CARMEL

State

Zip

62863

County

WABASH

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023