ROBERT CHARLES WELLIVER JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

CHARLES

Last Name

WELLIVER

Suffix

JR MD

Business Name

ROBERT CHARLES WELLIVER JR MD

Original Issue Date

07/08/2013

Effective Date

07/08/2013

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014