ANNA MARIE DE LA PENA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059545

License Status

CANCELLED

Business

Title

First Name

ANNA

Middle

MARIE

Last Name

DE LA PENA

Business Name

ANNA MARIE DE LA PENA MD

Original Issue Date

06/24/2011

Effective Date

06/24/2011

Expiration Date

06/23/2014

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/26/2011