DIOMEL M DE LA CRUZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129533

License Status

NOT RENEWED

Business

Title

First Name

DIOMEL

Middle

Last Name

DE LA CRUZ

Business Name

DIOMEL M DE LA CRUZ MD

Original Issue Date

01/31/2012

Effective Date

01/31/2012

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/17/2014