ELIZABETH B SEVERINO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

ELIZABETH B

Last Name

SEVERINO

Business Name

ELIZABETH B SEVERINO

Original Issue Date

07/21/1997

Effective Date

07/21/1997

Expiration Date

07/31/2005

City

MILLEDGEVILLE

State

Zip

61051

County

CARROLL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006