ROSAURA LICEA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030173

License Status

EXPIRED

Business

First Name

ROSAURA

Last Name

LICEA

Business Name

ROSAURA LICEA

Original Issue Date

06/08/1993

Effective Date

06/08/1993

Expiration Date

06/20/1996

City

OAK PARK

State

Zip

60301

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006