JARED DAVID CAPOUYA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036117317

License Status

NOT RENEWED

Business

First Name

JARED

Middle

DAVID

Last Name

CAPOUYA

Suffix

Business Name

JARED DAVID CAPOUYA MD

Original Issue Date

12/14/2006

Effective Date

12/14/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008