EDRICK J FERGUSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

ACTIVE

Business

Title

First Name

EDRICK

Middle

Last Name

FERGUSON

Business Name

EDRICK J FERGUSON MD

Original Issue Date

10/30/2024

Effective Date

10/30/2024

Expiration Date

07/31/2026

City

PORTAGE

State

Zip

49002

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/30/2024