KILALI IBIERE IYALLA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

ACTIVE

Business

Title

First Name

KILALI

Middle

IBIERE

Last Name

IYALLA

Business Name

KILALI IBIERE IYALLA MD

Original Issue Date

02/18/2021

Effective Date

07/14/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/14/2023