CHENELLE MAHALIA CHRYSTAL JOSEPH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

ACTIVE

Business

First Name

CHENELLE MAHALIA

Middle

CHRYSTAL

Last Name

JOSEPH

Suffix

Business Name

CHENELLE MAHALIA CHRYSTAL JOSEPH MD

Original Issue Date

10/06/2023

Effective Date

10/06/2023

Expiration Date

07/31/2026

City

GRAND FORKS

State

Zip

58201

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/06/2023