ANNA MARIE DE LA PENA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036134085

License Status

NOT RENEWED

Business

Title

First Name

ANNA

Middle

MARIE

Last Name

DE LA PENA

Business Name

ANNA MARIE DE LA PENA MD

Original Issue Date

10/17/2013

Effective Date

10/17/2013

Expiration Date

07/31/2014

City

NILES

State

Zip

60714

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014