DANIEL LEE MONTGOMERY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

NOT RENEWED

Business

Title

First Name

DANIEL

Middle

LEE

Last Name

MONTGOMERY

Business Name

DANIEL LEE MONTGOMERY MD

Original Issue Date

04/04/2014

Effective Date

04/04/2014

Expiration Date

07/31/2017

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017