ALFONSO A ORTIZ MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125020298

License Status

EXPIRED

Business

First Name

ALFONSO

Middle

Last Name

ORTIZ

Suffix

Business Name

ALFONSO A ORTIZ MD

Original Issue Date

09/04/1986

Effective Date

09/04/1986

Expiration Date

07/01/1989

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006