Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****19

NOT RENEWED

N

MD

VIJAY

K

MAHATHRE

VIJAY K MAHATHRE MD

04/14/1993

07/14/2014

07/31/2017

MACON

GA

31210

GEORGIA

PHARM DISTRIBUTOR

II III IV V

N

11/01/2017