POTENCIANO DIVIN GONZALES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036089452

License Status

NOT RENEWED

Business

First Name

POTENCIANO DIVIN

Last Name

GONZALES

Suffix

Business Name

POTENCIANO DIVIN GONZALES MD

Original Issue Date

08/26/1994

Effective Date

08/26/1994

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60659

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006