BRIAN LEE MARTIN DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****23

License Status

NOT RENEWED

Business

Title

DPM

First Name

BRIAN

Middle

LEE

Last Name

MARTIN

Business Name

BRIAN LEE MARTIN DPM

Original Issue Date

10/03/2006

Effective Date

12/21/2010

Expiration Date

01/31/2013

City

COLUMBIA

State

Zip

62236

County

MONROE

Specialty/Qualifier

PHARM DISTRIBUTOR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/20/2013