CARLOTA C NEPOMUCENO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

CANCELLED

Business

First Name

CARLOTA C

Last Name

NEPOMUCENO

Business Name

CARLOTA C NEPOMUCENO

Original Issue Date

08/03/1995

Effective Date

08/03/1995

Expiration Date

07/31/2005

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006