Individual
BETH PENSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1108 HARTMAN LN, BELLEVILLE, IL 62221-7921
(618) 239-6617
(618) 239-6625
Mailing address
2631 CASCADE LAKE DR, BELLEVILLE, IL 62221-8621
(618) 239-6617
(618) 239-6625
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.289115
IL
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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