DAISY MARTY PLACENCIA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

ACTIVE

Business

Title

First Name

DAISY

Last Name

MARTY PLACENCIA

Business Name

DAISY MARTY PLACENCIA MD

Original Issue Date

06/09/2022

Effective Date

05/11/2023

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/11/2023