BERT CLAIR ELIASON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

First Name

BERT

Middle

CLAIR

Last Name

ELIASON

Suffix

Business Name

BERT CLAIR ELIASON MD

Original Issue Date

03/05/1999

Effective Date

03/05/1999

Expiration Date

07/31/2008

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011