ALEXANDER P MATHAI Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

ACTIVE

Business

First Name

ALEXANDER

Middle

Last Name

MATHAI

Business Name

ALEXANDER P MATHAI

Original Issue Date

07/06/2005

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

FORT WAYNE

State

Zip

46835

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023