BRENO S PESSANHA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

BRENO

Middle

Last Name

PESSANHA

Suffix

Business Name

BRENO S PESSANHA MD

Original Issue Date

06/07/2005

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

PEORIA

State

Zip

61606

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011