MARTHA MENCHACA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040875

License Status

EXPIRED

Business

First Name

MARTHA

Last Name

MENCHACA

Business Name

MARTHA MENCHACA

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

08/25/2004

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006