JAN MICHAEL DULALAS RACOMA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

ACTIVE

Business

Title

First Name

JAN MICHAEL

Middle

DULALAS

Last Name

RACOMA

Business Name

JAN MICHAEL DULALAS RACOMA MD

Original Issue Date

05/14/2021

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/28/2026