MATTHEW BIRK MELLON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

NOT RENEWED

Business

Title

First Name

MATTHEW

Middle

BIRK

Last Name

MELLON

Business Name

MATTHEW BIRK MELLON MD

Original Issue Date

03/20/2014

Effective Date

03/20/2014

Expiration Date

07/31/2014

City

MILWAUKEE

State

Zip

53202

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014