JUSTINE ELODIA HENAO DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

ACTIVE

Business

Title

First Name

JUSTINE

Middle

ELODIA

Last Name

HENAO

Business Name

JUSTINE ELODIA HENAO DO

Original Issue Date

08/25/2023

Effective Date

08/25/2023

Expiration Date

07/31/2026

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/25/2023