MOLLY RENA ZAVALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

Title

First Name

MOLLY

Middle

RENA

Last Name

ZAVALA

Business Name

MOLLY RENA ZAVALA MD

Original Issue Date

07/07/2016

Effective Date

07/12/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021