SIMON KABUTUTWA 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

SIMON

Last Name

KABUTUTWA

Business Name

SIMON KABUTUTWA MD

Original Issue Date

10/25/2021

Effective Date

10/25/2021

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61602

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023