RALPH J DAMIANO JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

First Name

RALPH

Middle

Last Name

DAMIANO

Suffix

JR MD

Business Name

RALPH J DAMIANO JR MD

Original Issue Date

06/07/2004

Effective Date

09/27/2017

Expiration Date

09/30/2020

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021