ROY CLARENCE OSTBERG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036053862

License Status

NOT RENEWED

Business

First Name

ROY CLARENCE

Last Name

OSTBERG

Suffix

Business Name

ROY CLARENCE OSTBERG MD

Original Issue Date

11/19/1976

Effective Date

05/20/2014

Expiration Date

07/31/2017

City

BLOOMINGTON

State

Zip

61705

County

MCLEAN

Ever Disciplined

LastModifiedDate

11/01/2017