FLOR VELASCO EVANGELISTA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

ACTIVE

Business

First Name

FLOR VELASCO

Last Name

EVANGELISTA

Business Name

FLOR VELASCO EVANGELISTA

Original Issue Date

01/01/1997

Effective Date

07/04/2023

Expiration Date

07/31/2026

City

KEWANEE

State

Zip

61443

County

HENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/04/2023