PAOLA ALEXANDRA PESANTES MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

ACTIVE

Business

Title

First Name

PAOLA

Middle

ALEXANDRA

Last Name

PESANTES

Business Name

PAOLA ALEXANDRA PESANTES MD

Original Issue Date

06/13/2018

Effective Date

05/02/2023

Expiration Date

07/31/2026

City

LOVES PARK

State

Zip

61111

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2023