IAN ROBERT POWELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

ACTIVE

Business

Title

First Name

IAN

Middle

ROBERT

Last Name

POWELL

Business Name

IAN ROBERT POWELL MD

Original Issue Date

08/11/2021

Effective Date

05/05/2023

Expiration Date

07/31/2026

City

SUN PRAIRIE

State

Zip

53590

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/05/2023