MARTIN J FOWLER JR DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

NOT RENEWED

Business

Title

First Name

MARTIN

Middle

Last Name

FOWLER

Suffix

Business Name

MARTIN J FOWLER JR DO

Original Issue Date

09/16/2014

Effective Date

09/16/2014

Expiration Date

07/31/2017

City

RESTON

State

Zip

20190

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020