JOHN DALE ELLIOTT MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036124796

License Status

INACTIVE

Business

Title

First Name

JOHN

Middle

DALE

Last Name

ELLIOTT

Business Name

JOHN DALE ELLIOTT MD

Original Issue Date

01/04/2010

Effective Date

07/01/2014

Expiration Date

07/31/2017

City

MARYVILLE

State

Zip

62062

County

MADISON

Ever Disciplined

LastModifiedDate

07/01/2014