BRIAN THOMAS STUBITSCH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

CANCELLED

Business

First Name

BRIAN

Middle

THOMAS

Last Name

STUBITSCH

Suffix

Business Name

BRIAN THOMAS STUBITSCH MD

Original Issue Date

06/05/2000

Effective Date

06/05/2000

Expiration Date

07/31/2002

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017