ESTEBAN L BONFANTE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042040

License Status

EXPIRED

Business

First Name

ESTEBAN

Middle

Last Name

BONFANTE

Business Name

ESTEBAN L BONFANTE

Original Issue Date

07/12/2000

Effective Date

07/12/2000

Expiration Date

06/30/2004

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006