JON ELLIOTT DALE BRUBAKER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

ACTIVE

Business

Title

First Name

JON ELLIOTT

Middle

DALE

Last Name

BRUBAKER

Business Name

JON ELLIOTT DALE BRUBAKER MD

Original Issue Date

07/17/2023

Effective Date

07/17/2023

Expiration Date

07/31/2026

City

O'FALLON

State

Zip

62269

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/17/2023