JORDAN ANCELL ROSENBERG DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074663

License Status

CANCELLED

Business

Title

First Name

JORDAN

Middle

ANCELL

Last Name

ROSENBERG

Business Name

JORDAN ANCELL ROSENBERG DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/07/2019