SAJU S EAPEN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

First Name

SAJU S

Last Name

EAPEN

Business Name

SAJU S EAPEN

Original Issue Date

03/10/1998

Effective Date

03/10/1998

Expiration Date

07/31/1999

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006