LEO CHAPIN JENNETTEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125079471

License Status

CANCELLED

Business

Title

First Name

LEO

Middle

CHAPIN

Last Name

JENNETTEN

Business Name

LEO CHAPIN JENNETTEN MD

Original Issue Date

07/01/2025

Effective Date

07/01/2025

Expiration Date

06/30/2026

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

11/20/2025