License Number: ME105505

Data As Of 2/6/2023

Profession Medical Doctor
License ME105505
License Status CLEAR/ACTIVE
License Expiration Date 1/31/2024
License Original Issue Date 09/14/2009
Address of Record 201 REGENCY COURT
DOTHAN, AL 36305-1179
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain) No
Discipline on File No
Public Complaint No

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