JENNIFER P NEPOMUCENO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

NOT RENEWED

Business

First Name

JENNIFER P

Last Name

NEPOMUCENO

Business Name

JENNIFER P NEPOMUCENO

Original Issue Date

10/21/1991

Effective Date

07/21/2020

Expiration Date

07/31/2023

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023