LEONARDO CLAUDIO PROFENNA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

LEONARDO CLAUDIO

Last Name

PROFENNA

Suffix

Business Name

LEONARDO CLAUDIO PROFENNA MD

Original Issue Date

11/14/1996

Effective Date

11/14/1996

Expiration Date

07/31/1999

City

BELLEVILLE

State

Zip

62222

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011