BENJAMIN A VANRAALTE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

NOT RENEWED

Business

First Name

BENJAMIN A

Last Name

VANRAALTE

Suffix

Business Name

BENJAMIN A VANRAALTE MD

Original Issue Date

06/22/1994

Effective Date

06/22/1994

Expiration Date

07/31/1996

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020