DALE J ELLENBERG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036064065

License Status

NOT RENEWED

Business

First Name

DALE J

Last Name

ELLENBERG

Suffix

Business Name

DALE J ELLENBERG MD

Original Issue Date

03/22/1982

Effective Date

03/22/1982

Expiration Date

07/31/1987

City

BRIDGEWATER

State

Zip

02324

County

MASSACHUSETTS

Ever Disciplined

LastModifiedDate

09/20/2006