JUAN M MEDINA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036083564

License Status

ACTIVE

Business

First Name

JUAN

Middle

Last Name

MEDINA

Suffix

Business Name

JUAN M MEDINA MD

Original Issue Date

10/25/1991

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Ever Disciplined

LastModifiedDate

04/07/2023