BOLANLE M FAMAKIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

ACTIVE

Business

Title

First Name

BOLANLE

Middle

Last Name

FAMAKIN

Business Name

BOLANLE M FAMAKIN MD

Original Issue Date

01/31/2018

Effective Date

06/29/2023

Expiration Date

07/31/2026

City

MADISON

State

Zip

53705

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/29/2023