ROLAND BALUYOT MAWIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

NOT RENEWED

Business

First Name

ROLAND

Middle

BALUYOT

Last Name

MAWIS

Suffix

Business Name

ROLAND BALUYOT MAWIS MD

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

07/31/2008

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008