JUAN JOSE VAZQUEZ-BAUZA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

First Name

JUAN

Middle

JOSE

Last Name

VAZQUEZ-BAUZA

Business Name

JUAN JOSE VAZQUEZ-BAUZA

Original Issue Date

05/02/2020

Effective Date

05/02/2020

Expiration Date

07/31/2023

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023