JUSTIN CRAIG ELLERBROEK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

Title

First Name

JUSTIN

Middle

CRAIG

Last Name

ELLERBROEK

Business Name

JUSTIN CRAIG ELLERBROEK MD

Original Issue Date

08/17/2011

Effective Date

08/17/2011

Expiration Date

07/31/2014

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014