ALFONSO JAVIER MEDINA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036035151

License Status

NOT RENEWED

Business

First Name

ALFONSO JAVIER

Last Name

MEDINA

Suffix

Business Name

ALFONSO JAVIER MEDINA MD

Original Issue Date

03/21/1958

Effective Date

04/14/2011

Expiration Date

07/31/2014

City

FLOSSMOOR

State

Zip

60422

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014