ANTHONY PHILIP DE LA PENA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

ACTIVE

Business

Title

First Name

ANTHONY

Middle

PHILIP

Last Name

DE LA PENA

Business Name

ANTHONY PHILIP DE LA PENA MD

Original Issue Date

07/15/2019

Effective Date

07/06/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/06/2023