DOUGLAS F PENATE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059447

License Status

CANCELLED

Business

Title

First Name

DOUGLAS

Middle

Last Name

PENATE

Business Name

DOUGLAS F PENATE MD

Original Issue Date

06/22/2011

Effective Date

06/22/2011

Expiration Date

06/21/2014

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014