ROBERTO CARLOS B COLLANTES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

ROBERTO CARLOS

Middle

Last Name

COLLANTES

Suffix

Business Name

ROBERTO CARLOS B COLLANTES MD

Original Issue Date

04/09/2009

Effective Date

05/23/2011

Expiration Date

07/31/2014

City

COLUMBIA

State

Zip

62236

County

MONROE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014