VIBHAV KRISHAN BANSAL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

ACTIVE

Business

Title

First Name

VIBHAV

Middle

KRISHAN

Last Name

BANSAL

Business Name

VIBHAV KRISHAN BANSAL MD

Original Issue Date

10/29/2014

Effective Date

08/17/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61114

County

BOONE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/17/2023