ANGELA BENAVIDES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

NOT RENEWED

Business

First Name

ANGELA

Last Name

BENAVIDES

Suffix

Business Name

ANGELA BENAVIDES MD

Original Issue Date

03/06/1987

Effective Date

08/19/2020

Expiration Date

07/31/2023

City

PERU

State

Zip

61354

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023