RALPH I LATTA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

ACTIVE

Business

First Name

RALPH I

Last Name

LATTA

Business Name

RALPH I LATTA

Original Issue Date

12/12/2005

Effective Date

07/07/2023

Expiration Date

07/31/2026

City

BENTON

State

Zip

62812

County

FRANKLIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/07/2023