SANDRA MARIE PENA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

ACTIVE

Business

Title

First Name

SANDRA

Middle

MARIE

Last Name

PENA

Business Name

SANDRA MARIE PENA MD

Original Issue Date

09/12/2019

Effective Date

05/13/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/13/2023