J MICHAEL ZINZILIETA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

J MICHAEL

Last Name

ZINZILIETA

Suffix

Business Name

J MICHAEL ZINZILIETA MD

Original Issue Date

01/01/1997

Effective Date

06/09/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021