PEDRO BANTUG DE GUZMAN JR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

ACTIVE

Business

First Name

PEDRO BANTUG

Last Name

DE GUZMAN JR

Suffix

Business Name

PEDRO BANTUG DE GUZMAN JR MD

Original Issue Date

08/06/1996

Effective Date

08/01/2023

Expiration Date

07/31/2026

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/01/2023