ERICA LANE CONRAD MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

ACTIVE

Business

Title

First Name

ERICA

Middle

LANE

Last Name

CONRAD

Business Name

ERICA LANE CONRAD MD

Original Issue Date

01/06/2022

Effective Date

07/03/2023

Expiration Date

07/31/2026

City

ROCHESTER

State

Zip

62563

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/03/2023