GUSTAVO A DIAZ-REYES Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043834

License Status

EXPIRED

Business

First Name

GUSTAVO

Middle

Last Name

DIAZ-REYES

Business Name

GUSTAVO A DIAZ-REYES

Original Issue Date

02/05/2002

Effective Date

02/05/2002

Expiration Date

06/30/2005

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

09/22/2006