ENRIQUE MENDIVIL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036044627

License Status

NOT RENEWED

Business

First Name

ENRIQUE

Last Name

MENDIVIL

Suffix

Business Name

ENRIQUE MENDIVIL MD

Original Issue Date

08/09/1971

Effective Date

08/09/1971

Expiration Date

07/31/2002

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/09/2006