EUGENIO L MENDOZA IV 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

EUGENIO L

Last Name

MENDOZA IV

Suffix

Business Name

EUGENIO L MENDOZA IV MD

Original Issue Date

10/05/1987

Effective Date

06/29/2011

Expiration Date

07/31/2014

City

DIXON

State

Zip

61021

County

LEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020