STEPHEN T PENEPACKER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

STEPHEN

Middle

Last Name

PENEPACKER

Business Name

STEPHEN T PENEPACKER

Original Issue Date

02/15/2007

Effective Date

07/07/2020

Expiration Date

07/31/2023

City

ARROYO GRANDE

State

Zip

93420

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023