ANGELA BEALE MARTIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

Title

First Name

ANGELA

Middle

BEALE

Last Name

MARTIN

Business Name

ANGELA BEALE MARTIN MD

Original Issue Date

05/07/2013

Effective Date

07/21/2014

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017