AMY ERNA LIEPERT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

Title

First Name

AMY

Middle

ERNA

Last Name

LIEPERT

Business Name

AMY ERNA LIEPERT MD

Original Issue Date

06/28/2013

Effective Date

06/28/2013

Expiration Date

07/31/2014

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/17/2014