DANIEL JON OSTLIE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036131973

License Status

NOT RENEWED

Business

Title

First Name

DANIEL

Middle

JON

Last Name

OSTLIE

Business Name

DANIEL JON OSTLIE MD

Original Issue Date

01/30/2013

Effective Date

07/07/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/01/2017