HOMER PENA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036070398

License Status

NOT RENEWED

Business

First Name

HOMER

Last Name

PENA

Suffix

Business Name

HOMER PENA MD

Original Issue Date

04/15/1985

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

01/14/2021