JUSTIN A ROSE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

ACTIVE

Business

Title

First Name

JUSTIN

Middle

Last Name

ROSE

Business Name

JUSTIN A ROSE DO

Original Issue Date

11/07/2018

Effective Date

05/11/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/11/2023