BEMNET BALCHA HAILU MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

ACTIVE

Business

Title

First Name

BEMNET

Middle

BALCHA

Last Name

HAILU

Business Name

BEMNET BALCHA HAILU MD

Original Issue Date

03/27/2019

Effective Date

04/16/2023

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

04/16/2023