FAUSTINO VIRATA PUGEDA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

Title

First Name

FAUSTINO

Middle

VIRATA

Last Name

PUGEDA

Business Name

FAUSTINO VIRATA PUGEDA MD

Original Issue Date

01/01/1997

Effective Date

02/27/2018

Expiration Date

09/30/2020

City

MARION

State

Zip

62959

County

WILLIAMSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021