STAFFORD AUSTIN CONWAY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

Title

First Name

STAFFORD

Middle

AUSTIN

Last Name

CONWAY

Business Name

STAFFORD AUSTIN CONWAY MD

Original Issue Date

12/31/2022

Effective Date

12/31/2022

Expiration Date

07/31/2023

City

JOHNSON CITY

State

Zip

37604

County

WASHINGTON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023