JAMIE LEE ELLIOTT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

NOT RENEWED

Business

Title

First Name

JAMIE

Middle

LEE

Last Name

ELLIOTT

Business Name

JAMIE LEE ELLIOTT MD

Original Issue Date

06/14/2016

Effective Date

04/27/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61104

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/16/2023