MICHAEL P BONAVENTURA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125014726

License Status

EXPIRED

Business

First Name

MICHAEL

Middle

Last Name

BONAVENTURA

Business Name

MICHAEL P BONAVENTURA

Original Issue Date

07/14/1982

Effective Date

07/14/1982

Expiration Date

07/01/1984

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006