MAURICIO E PALENCIA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038376

License Status

EXPIRED

Business

First Name

MAURICIO

Middle

Last Name

PALENCIA

Business Name

MAURICIO E PALENCIA

Original Issue Date

07/01/1998

Effective Date

07/01/1998

Expiration Date

06/30/2001

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006