JAVIER MARUENDA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

First Name

JAVIER

Last Name

MARUENDA

Business Name

JAVIER MARUENDA

Original Issue Date

08/13/1996

Effective Date

08/13/1996

Expiration Date

07/31/1999

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006