IJAZ AHMAD JATALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

NOT RENEWED

Business

First Name

IJAZ AHMAD

Last Name

JATALA

Suffix

Business Name

IJAZ AHMAD JATALA MD

Original Issue Date

01/01/1997

Effective Date

07/14/2008

Expiration Date

07/31/2011

City

INA

State

Zip

62846

County

JEFFERSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011