JUSTIN L GOTTLIEB MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

ACTIVE

Business

First Name

JUSTIN L

Last Name

GOTTLIEB

Suffix

Business Name

JUSTIN L GOTTLIEB MD

Original Issue Date

07/25/1997

Effective Date

04/21/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/21/2023