DWIGHT F PENTZIEN JR DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036090963

License Status

ACTIVE

Business

Title

First Name

DWIGHT F

Last Name

PENTZIEN JR

Business Name

DWIGHT F PENTZIEN JR DO

Original Issue Date

06/21/1995

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

04/06/2023