MATTHEW KOTTACKAL GEORGE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

ACTIVE

Business

Title

First Name

MATTHEW

Middle

KOTTACKAL

Last Name

GEORGE

Business Name

MATTHEW KOTTACKAL GEORGE MD

Original Issue Date

08/09/2023

Effective Date

08/09/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/09/2023