ERNESTO L MARTIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

NOT RENEWED

Business

First Name

ERNESTO

Middle

Last Name

MARTIN

Suffix

Business Name

ERNESTO L MARTIN MD

Original Issue Date

12/21/1994

Effective Date

12/21/1994

Expiration Date

07/31/2008

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/16/2008

Case Number

2007009767

Action

Summary Suspension

Discipline Start Date

01/16/2008

Discipline End Date

05/16/2008