JERELL DIEGO CHUA DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036128813

License Status

INACTIVE

Business

Title

First Name

JERELL

Middle

DIEGO

Last Name

CHUA

Business Name

JERELL DIEGO CHUA DO

Original Issue Date

08/18/2011

Effective Date

08/18/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

04/08/2014