BENJAMIN A VANRAALTE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

ACTIVE

Business

First Name

BENJAMIN A

Last Name

VANRAALTE

Suffix

Business Name

BENJAMIN A VANRAALTE MD

Original Issue Date

01/19/1984

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

DAVENPORT

State

Zip

52807

County

IOWA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023