GINO E MENDOZA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035439

License Status

EXPIRED

Business

First Name

GINO

Middle

Last Name

MENDOZA

Business Name

GINO E MENDOZA

Original Issue Date

07/22/1996

Effective Date

07/22/1996

Expiration Date

07/18/1999

City

CHICAGO

State

Zip

60627

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006