WALTER OMUKO MOGENI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

ACTIVE

Business

Title

First Name

WALTER

Middle

OMUKO

Last Name

MOGENI

Business Name

WALTER OMUKO MOGENI MD

Original Issue Date

09/20/2024

Effective Date

09/20/2024

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61603

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/20/2024