ANGEL R MESA Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036461

License Status

CANCELLED

Business

First Name

ANGEL

Middle

Last Name

MESA

Business Name

ANGEL R MESA

Original Issue Date

06/06/1997

Effective Date

06/06/1997

Expiration Date

06/30/2000

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006