MARK P ILTIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

First Name

MARK P

Last Name

ILTIS

Suffix

Business Name

MARK P ILTIS MD

Original Issue Date

05/06/2009

Effective Date

05/01/2014

Expiration Date

07/31/2017

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017