IJAZ AHMAD JATALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

First Name

IJAZ AHMAD

Last Name

JATALA

Suffix

Business Name

IJAZ AHMAD JATALA MD

Original Issue Date

06/27/1985

Effective Date

06/27/1985

Expiration Date

07/31/1990

City

GRANITE CITY

State

Zip

62040

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011