ROY CLARENCE OSTBERG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

ROY CLARENCE

Last Name

OSTBERG

Suffix

Business Name

ROY CLARENCE OSTBERG MD

Original Issue Date

08/09/1984

Effective Date

08/09/1984

Expiration Date

07/31/1999

City

PERU

State

Zip

61354

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017