DERRICK EARNEST ROLLO DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

ACTIVE

Business

First Name

DERRICK

Middle

EARNEST

Last Name

ROLLO

Suffix

Business Name

DERRICK EARNEST ROLLO DO

Original Issue Date

12/11/2008

Effective Date

04/22/2023

Expiration Date

07/31/2026

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/22/2023