RAFAEL L GALLARDO 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

RAFAEL

Middle

Last Name

GALLARDO

Suffix

Business Name

RAFAEL L GALLARDO MD

Original Issue Date

02/16/2006

Effective Date

06/05/2017

Expiration Date

09/30/2020

City

MARTINSVILLE

State

Zip

62442

County

CLARK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021