JUAN GODINEZ-PUEBLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

First Name

JUAN

Last Name

GODINEZ-PUEBLA

Suffix

Business Name

JUAN GODINEZ-PUEBLA MD

Original Issue Date

08/05/1994

Effective Date

08/05/1994

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006