SAJU S EAPEN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

NOT RENEWED

Business

First Name

SAJU S

Last Name

EAPEN

Business Name

SAJU S EAPEN

Original Issue Date

05/04/1998

Effective Date

05/04/1998

Expiration Date

07/31/1999

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006