MICHITAKA KAWATA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

Title

First Name

MICHITAKA

Last Name

KAWATA

Business Name

MICHITAKA KAWATA MD

Original Issue Date

03/10/2016

Effective Date

08/02/2017

Expiration Date

09/30/2020

City

MARION

State

Zip

62959

County

WILLIAMSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021