OCTAVIO CIEZA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036099263

License Status

NOT RENEWED

Business

First Name

OCTAVIO

Last Name

CIEZA

Suffix

Business Name

OCTAVIO CIEZA MD

Original Issue Date

10/30/1998

Effective Date

10/30/1998

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006