BENNETT PETER SCAGLIA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

First Name

BENNETT PETER

Last Name

SCAGLIA

Suffix

Business Name

BENNETT PETER SCAGLIA MD

Original Issue Date

08/25/1997

Effective Date

07/21/2011

Expiration Date

07/31/2014

City

NORMAL

State

Zip

61761

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014