DARRELL WAYNE GONZALES MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044540

License Status

EXPIRED

Business

First Name

DARRELL

Middle

WAYNE

Last Name

GONZALES

Suffix

Business Name

DARRELL WAYNE GONZALES MD

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2005

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

09/22/2006