JOSE A PENAHERRERA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

First Name

JOSE A

Last Name

PENAHERRERA

Suffix

Business Name

JOSE A PENAHERRERA MD

Original Issue Date

04/07/1997

Effective Date

07/17/2017

Expiration Date

09/30/2020

City

NEW LENOX

State

Zip

60451

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021