MENA HENIEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075796

License Status

CANCELLED

Business

Title

First Name

MENA

Last Name

HENIEN

Business Name

MENA HENIEN MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2023

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/24/2020