HENRY A SAN GERMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

First Name

HENRY A

Last Name

SAN GERMAN

Suffix

Business Name

HENRY A SAN GERMAN MD

Original Issue Date

01/30/1996

Effective Date

01/30/1996

Expiration Date

07/31/1996

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020