KRISTIAN R HENRIQUEZ MIRANDONA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036140997

License Status

NOT RENEWED

Business

Title

First Name

KRISTIAN

Middle

Last Name

HENRIQUEZ MIRANDONA

Business Name

KRISTIAN R HENRIQUEZ MIRANDONA MD

Original Issue Date

06/21/2016

Effective Date

05/11/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021