MICHAEL ALAN MASTELLER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

ACTIVE

Business

Title

First Name

MICHAEL

Middle

ALAN

Last Name

MASTELLER

Business Name

MICHAEL ALAN MASTELLER MD

Original Issue Date

07/08/2016

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61114

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023