JESUS MENDIOLAZA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

ACTIVE

Business

First Name

JESUS

Last Name

MENDIOLAZA

Suffix

Business Name

JESUS MENDIOLAZA MD

Original Issue Date

02/24/2022

Effective Date

07/10/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61636

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/10/2023