ARLI MEDINA BUMATAYO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

ACTIVE

Business

Title

First Name

ARLI

Middle

MEDINA

Last Name

BUMATAYO

Business Name

ARLI MEDINA BUMATAYO MD

Original Issue Date

05/03/2013

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023