FAUSTO R LORA MIR Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036084051

License Status

INACTIVE

Business

First Name

FAUSTO R

Last Name

LORA MIR

Business Name

FAUSTO R LORA MIR

Original Issue Date

02/29/1992

Effective Date

06/23/2011

Expiration Date

07/31/2014

City

COUNTRYSIDE

State

Zip

60525

County

COOK

Ever Disciplined

LastModifiedDate

04/08/2014