RUTHIE REBECCA SU MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

ACTIVE

Business

Title

First Name

RUTHIE

Middle

REBECCA

Last Name

Business Name

RUTHIE REBECCA SU MD

Original Issue Date

11/01/2018

Effective Date

06/08/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/08/2023