JAVIER J DIAZ BLANCO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016253

License Status

EXPIRED

Business

First Name

JAVIER

Middle

Last Name

DIAZ BLANCO

Business Name

JAVIER J DIAZ BLANCO

Original Issue Date

07/25/1983

Effective Date

07/25/1983

Expiration Date

07/01/1985

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006