DAN SOTOLONGO JIMENEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

Title

First Name

DAN

Last Name

SOTOLONGO JIMENEZ

Business Name

DAN SOTOLONGO JIMENEZ MD

Original Issue Date

09/10/2020

Effective Date

09/10/2020

Expiration Date

07/31/2023

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023