SUNIL RUIZ BANSAL 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

SUNIL

Middle

RUIZ

Last Name

BANSAL

Suffix

Business Name

SUNIL RUIZ BANSAL MD

Original Issue Date

03/08/2000

Effective Date

07/28/2011

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014