RAQUEL Z MALABANAN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

RAQUEL Z

Last Name

MALABANAN

Business Name

RAQUEL Z MALABANAN

Original Issue Date

07/31/1995

Effective Date

07/19/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021