HABTAMU PETROS HANDRO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

First Name

HABTAMU

Middle

PETROS

Last Name

HANDRO

Suffix

Business Name

HABTAMU PETROS HANDRO MD

Original Issue Date

01/28/2004

Effective Date

01/28/2004

Expiration Date

07/31/2005

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006