JENIE S NEPOMUCENO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

NOT RENEWED

Business

First Name

JENIE S

Last Name

NEPOMUCENO

Suffix

Business Name

JENIE S NEPOMUCENO MD

Original Issue Date

07/30/1991

Effective Date

07/30/1991

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020