JOHN DALE ELLIOTT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

NOT RENEWED

Business

Title

First Name

JOHN

Middle

DALE

Last Name

ELLIOTT

Business Name

JOHN DALE ELLIOTT MD

Original Issue Date

01/05/2010

Effective Date

07/01/2014

Expiration Date

07/31/2017

City

MARYVILLE

State

Zip

62062

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017