STEFANIE MARTIN DIAZ MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032171

License Status

EXPIRED

Business

First Name

STEFANIE

Middle

MARTIN

Last Name

DIAZ

Suffix

Business Name

STEFANIE MARTIN DIAZ MD

Original Issue Date

07/12/1994

Effective Date

07/12/1994

Expiration Date

07/11/1997

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006