FREDERICK BERNAB E CORPUZ - Medical Doctor License in Illinois | # 125031272

FREDERICK BERNAB E CORPUZ

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031272

License Status

EXPIRED

Business

N

First Name

FREDERICK BERNAB

Middle

E

Last Name

CORPUZ

Business Name

FREDERICK BERNAB E CORPUZ

Original Issue Date

05/20/1994

Effective Date

05/20/1994

Expiration Date

06/23/1997

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006