RAQUEL BALAJADIA EMPEDRAD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

RAQUEL

Middle

BALAJADIA

Last Name

EMPEDRAD

Suffix

Business Name

RAQUEL BALAJADIA EMPEDRAD MD

Original Issue Date

05/28/2002

Effective Date

05/28/2002

Expiration Date

07/31/2008

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008