GLENN BANEGURA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

ACTIVE

Business

Title

First Name

GLENN

Last Name

BANEGURA

Business Name

GLENN BANEGURA MD

Original Issue Date

12/01/2018

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

LILBURN

State

Zip

30047

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023