ANTONIO RESUMA PENILLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

NOT RENEWED

Business

First Name

ANTONIO RESUMA

Last Name

PENILLA

Suffix

Business Name

ANTONIO RESUMA PENILLA MD

Original Issue Date

05/19/1997

Effective Date

07/29/2014

Expiration Date

07/31/2017

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020