CARMEN SOCORRO MANSILLA-ORIHUELA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

CARMEN SOCORRO

Last Name

MANSILLA-ORIHUELA

Business Name

CARMEN SOCORRO MANSILLA-ORIHUELA

Original Issue Date

10/30/2001

Effective Date

10/30/2001

Expiration Date

07/31/2005

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/09/2006