RUDOLPH ELROY BRANCH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

NOT RENEWED

Business

First Name

RUDOLPH

Middle

ELROY

Last Name

BRANCH

Suffix

Business Name

RUDOLPH ELROY BRANCH MD

Original Issue Date

08/16/1999

Effective Date

08/16/1999

Expiration Date

07/31/2002

City

HERRIN

State

Zip

62948

County

WILLIAMSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006