MARK P ILTIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

First Name

MARK P

Last Name

ILTIS

Suffix

Business Name

MARK P ILTIS MD

Original Issue Date

05/04/1995

Effective Date

05/04/1995

Expiration Date

07/31/2002

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017