HOMER PENA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016379

License Status

EXPIRED

Business

First Name

HOMER

Last Name

PENA

Suffix

Business Name

HOMER PENA MD

Original Issue Date

08/18/1983

Effective Date

08/18/1983

Expiration Date

07/01/1985

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006