JOSE A PENAHERRERA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031054

License Status

EXPIRED

Business

First Name

JOSE A

Last Name

PENAHERRERA

Suffix

Business Name

JOSE A PENAHERRERA MD

Original Issue Date

05/10/1994

Effective Date

05/10/1994

Expiration Date

06/25/1997

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006