PATRICE MORENO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036059411

License Status

NOT RENEWED

Business

First Name

PATRICE

Last Name

MORENO

Suffix

Business Name

PATRICE MORENO MD

Original Issue Date

09/18/1979

Effective Date

09/18/1979

Expiration Date

07/01/1982

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006