LUIS C DE VENECIA JR 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

LUIS C

Last Name

DE VENECIA JR

Business Name

LUIS C DE VENECIA JR

Original Issue Date

04/28/1997

Effective Date

04/28/1997

Expiration Date

07/31/1999

City

CLAY CITY

State

Zip

62824

County

CLAY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020