JUAN CARLOS DIEGO PENHOS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

JUAN CARLOS

Middle

DIEGO

Last Name

PENHOS

Suffix

Business Name

JUAN CARLOS DIEGO PENHOS MD

Original Issue Date

04/10/2000

Effective Date

04/10/2000

Expiration Date

07/31/2002

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

04/12/2017