VIREN R VANKAWALA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

First Name

VIREN

Middle

Last Name

VANKAWALA

Business Name

VIREN R VANKAWALA

Original Issue Date

01/23/2004

Effective Date

01/23/2004

Expiration Date

07/31/2008

City

DECATUR

State

Zip

62524

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008