TRAVIS MICHAEL COSBAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

ACTIVE

Business

Title

First Name

TRAVIS

Middle

MICHAEL

Last Name

COSBAN

Business Name

TRAVIS MICHAEL COSBAN MD

Original Issue Date

05/21/2022

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023