BENJAMIN ELLISON COLLIE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

ACTIVE

Business

Title

First Name

BENJAMIN

Middle

ELLISON

Last Name

COLLIE

Business Name

BENJAMIN ELLISON COLLIE MD

Original Issue Date

06/18/2020

Effective Date

05/08/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/08/2023