ROSE ELAINE PAUL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

CANCELLED

Business

First Name

ROSE

Middle

ELAINE

Last Name

PAUL

Suffix

Business Name

ROSE ELAINE PAUL MD

Original Issue Date

10/13/2000

Effective Date

10/13/2000

Expiration Date

07/31/2005

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006