LAURIE ANN 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

First Name

LAURIE

Middle

ANN

Last Name

MARTIN

Suffix

Business Name

LAURIE ANN MARTIN MD

Original Issue Date

06/04/1999

Effective Date

06/04/1999

Expiration Date

07/31/2002

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II IV

Ever Disciplined

LastModifiedDate

10/09/2006