REBECCA HARTOG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

ACTIVE

Business

Title

First Name

REBECCA

Last Name

HARTOG

Business Name

REBECCA HARTOG MD

Original Issue Date

08/11/2021

Effective Date

07/04/2023

Expiration Date

07/31/2026

City

CENTREVILLE

State

Zip

62207

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/04/2023