ANTHONY PHILIP DE LA PENA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068238

License Status

CANCELLED

Business

Title

First Name

ANTHONY

Middle

PHILIP

Last Name

DE LA PENA

Business Name

ANTHONY PHILIP DE LA PENA MD

Original Issue Date

06/24/2016

Effective Date

06/24/2016

Expiration Date

06/23/2019

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/09/2016