RENATO MENDOZA FONTANILLA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034958

License Status

CANCELLED

Business

First Name

RENATO MENDOZA

Last Name

FONTANILLA

Suffix

Business Name

RENATO MENDOZA FONTANILLA MD

Original Issue Date

06/12/1996

Effective Date

06/12/1996

Expiration Date

06/30/1999

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Neonatal-Perinatal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006