VIJIL KOMANTHAKKAL RAHULAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

NOT RENEWED

Business

Title

First Name

VIJIL

Middle

KOMANTHAKKAL

Last Name

RAHULAN

Business Name

VIJIL KOMANTHAKKAL RAHULAN MD

Original Issue Date

12/19/2013

Effective Date

07/17/2017

Expiration Date

09/30/2020

City

GRANDVILLE

State

Zip

49418

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021