JOSEFINA L S CANCINO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

NOT RENEWED

Business

First Name

JOSEFINA L S

Last Name

CANCINO

Suffix

Business Name

JOSEFINA L S CANCINO MD

Original Issue Date

01/30/1996

Effective Date

01/30/1996

Expiration Date

07/31/1999

City

SALEM

State

Zip

62881

County

MARION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006