ROGER CEPEDA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****13

License Status

NOT RENEWED

Business

First Name

ROGER

Last Name

CEPEDA

Business Name

ROGER CEPEDA

Original Issue Date

09/15/2020

Effective Date

09/15/2020

Expiration Date

03/01/2022

City

PEORIA

State

Zip

61637

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022