JUSTIN ELLIS COSTELLO DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036143252

License Status

ACTIVE

Business

Title

First Name

JUSTIN

Middle

ELLIS

Last Name

COSTELLO

Business Name

JUSTIN ELLIS COSTELLO DO

Original Issue Date

05/25/2017

Effective Date

08/01/2023

Expiration Date

07/31/2026

City

OMAHA

State

Zip

68114

Ever Disciplined

LastModifiedDate

08/01/2023