IAN GREEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

ACTIVE

Business

Title

First Name

IAN

Last Name

GREEN

Business Name

IAN GREEN MD

Original Issue Date

05/04/2023

Effective Date

05/04/2023

Expiration Date

07/31/2026

City

PHILADELPHIA

State

Zip

19107

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/04/2023