License Number: ME105890

Data As Of 12/5/2023

Profession Medical Doctor
License ME105890
License Status CLEAR/ACTIVE
License Expiration Date 1/31/2024
License Original Issue Date 11/25/2009
Address of Record 1 DAVIS BLVD
TAMPA, FL 33606
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain) Yes
Discipline on File No
Public Complaint No

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