BERNARDITA R ENRIQUEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

First Name

BERNARDITA R

Last Name

ENRIQUEZ

Suffix

Business Name

BERNARDITA R ENRIQUEZ MD

Original Issue Date

08/10/1983

Effective Date

05/02/2014

Expiration Date

07/31/2017

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017