RACHEL KURNIADI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

RACHEL

Last Name

KURNIADI

Suffix

Business Name

RACHEL KURNIADI MD

Original Issue Date

08/03/1993

Effective Date

08/03/1993

Expiration Date

07/31/2005

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006