RENATO S ENRIQUEZ 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

RENATO S

Last Name

ENRIQUEZ

Suffix

Business Name

RENATO S ENRIQUEZ MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2008

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

04/07/2011