FLOTILLO BRUCE WATKINS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

FLOTILLO

Middle

BRUCE

Last Name

WATKINS

Business Name

FLOTILLO BRUCE WATKINS

Original Issue Date

07/19/2001

Effective Date

07/30/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61111

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020