PENINNAH M MUTUNGI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

ACTIVE

Business

First Name

PENINNAH

Middle

Last Name

MUTUNGI

Suffix

Business Name

PENINNAH M MUTUNGI MD

Original Issue Date

02/28/2008

Effective Date

05/16/2023

Expiration Date

07/31/2026

City

MARYVILLE

State

Zip

62062

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/16/2023