BENNETT PETER SCAGLIA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

First Name

BENNETT PETER

Last Name

SCAGLIA

Suffix

Business Name

BENNETT PETER SCAGLIA MD

Original Issue Date

06/10/1994

Effective Date

06/10/1994

Expiration Date

07/31/2005

City

OTTAWA

State

Zip

61350

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011