CHAD MICHAEL ENNIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

ACTIVE

Business

Title

First Name

CHAD

Middle

MICHAEL

Last Name

ENNIS

Business Name

CHAD MICHAEL ENNIS MD

Original Issue Date

10/27/2023

Effective Date

10/27/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61104

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/27/2023