CARMELITO MIRALL CARONONGAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

CARMELITO MIRALL

Last Name

CARONONGAN

Suffix

Business Name

CARMELITO MIRALL CARONONGAN MD

Original Issue Date

07/28/1982

Effective Date

06/26/2014

Expiration Date

07/31/2017

City

HERRIN

State

Zip

62948

County

WILLIAMSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017