LAURA M MARTIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

First Name

LAURA M

Last Name

MARTIN

Suffix

Business Name

LAURA M MARTIN MD

Original Issue Date

08/31/1989

Effective Date

08/31/1989

Expiration Date

07/31/1999

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006