PENELOPE ANN EWBANK Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104932

License Status

ACTIVE

Business

First Name

PENELOPE

Middle

ANN

Last Name

EWBANK

Business Name

PENELOPE ANN EWBANK

Original Issue Date

06/07/2001

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

04/11/2023