AMANDA G JUDILLA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

ACTIVE

Business

Title

First Name

AMANDA

Middle

Last Name

JUDILLA

Business Name

AMANDA G JUDILLA MD

Original Issue Date

12/17/2022

Effective Date

06/28/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63104

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/28/2023