ROSA UBILLUZ BANGHART MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

First Name

ROSA UBILLUZ

Last Name

BANGHART

Suffix

Business Name

ROSA UBILLUZ BANGHART MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2005

City

CHARLESTON

State

Zip

61920

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006