VINNY MANJALY VARGHESE 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

VINNY

Middle

MANJALY

Last Name

VARGHESE

Suffix

Business Name

VINNY MANJALY VARGHESE MD

Original Issue Date

06/10/2002

Effective Date

06/10/2002

Expiration Date

07/31/2005

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006