HOMER PENA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

HOMER

Last Name

PENA

Suffix

Business Name

HOMER PENA MD

Original Issue Date

06/20/1985

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61606

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021