ERIC D BULLOCK Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

ACTIVE

Business

First Name

ERIC

Middle

Last Name

BULLOCK

Business Name

ERIC D BULLOCK

Original Issue Date

04/09/2001

Effective Date

07/29/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/29/2023