MICHAEL THOMAS AMBROSE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036128279

License Status

ACTIVE

Business

First Name

MICHAEL

Middle

THOMAS

Last Name

AMBROSE

Suffix

Business Name

MICHAEL THOMAS AMBROSE MD

Original Issue Date

06/29/2011

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

04/11/2023