RODOLFO JAVIER SAN JUAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

ACTIVE

Business

Title

First Name

RODOLFO

Middle

JAVIER

Last Name

SAN JUAN

Business Name

RODOLFO JAVIER SAN JUAN MD

Original Issue Date

05/25/2025

Effective Date

05/25/2025

Expiration Date

07/31/2026

City

CROWN POINT

State

Zip

46307

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/09/2025