CAROLYN MARIE D'AMBROSIO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

NOT RENEWED

Business

Title

First Name

CAROLYN

Middle

MARIE

Last Name

D'AMBROSIO

Business Name

CAROLYN MARIE D'AMBROSIO MD

Original Issue Date

09/18/2014

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021