RENEITA V ROSS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

RENEITA

Middle

Last Name

ROSS

Suffix

Business Name

RENEITA V ROSS MD

Original Issue Date

05/06/2009

Effective Date

06/29/2011

Expiration Date

07/31/2014

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

04/05/2020