MICHAEL JOHN D'AMBROSE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

JOHN

Last Name

D'AMBROSE

Business Name

MICHAEL JOHN D'AMBROSE MD

Original Issue Date

05/17/2019

Effective Date

05/17/2019

Expiration Date

09/30/2020

City

HILLSORO

State

Zip

62049

County

MONTGOMERY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021