JULIO EDUARDO DE PENA FERNANDEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

Title

First Name

JULIO

Middle

EDUARDO

Last Name

DE PENA FERNANDEZ

Business Name

JULIO EDUARDO DE PENA FERNANDEZ MD

Original Issue Date

07/14/2016

Effective Date

07/17/2017

Expiration Date

09/30/2020

City

WAXHAW

State

Zip

28173

County

UNION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/29/2025