RANJITH B DISSANAYAKE 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

RANJITH

Middle

Last Name

DISSANAYAKE

Business Name

RANJITH B DISSANAYAKE

Original Issue Date

01/24/2001

Effective Date

01/24/2001

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020