TERRENCE L PENCEK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

First Name

TERRENCE L

Last Name

PENCEK

Suffix

Business Name

TERRENCE L PENCEK MD

Original Issue Date

08/01/1989

Effective Date

07/20/2011

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014