MICHAEL AN DPM Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****88

License Status

ACTIVE

Business

Title

DPM

First Name

MICHAEL

Last Name

Business Name

MICHAEL AN DPM

Original Issue Date

07/23/2024

Effective Date

11/26/2024

Expiration Date

01/31/2027

City

HERRIN

State

Zip

62948

County

WILLIAMSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/26/2024