ELEANOR RESANE BANZON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

ACTIVE

Business

Title

First Name

ELEANOR

Middle

RESANE

Last Name

BANZON

Business Name

ELEANOR RESANE BANZON MD

Original Issue Date

02/22/2016

Effective Date

05/04/2023

Expiration Date

07/31/2026

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/04/2023