JUAN M MEDINA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

ACTIVE

Business

First Name

JUAN

Middle

Last Name

MEDINA

Suffix

Business Name

JUAN M MEDINA MD

Original Issue Date

11/15/1991

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023