JOAQUINA ELIZABETH VIDES DE MONTOYA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045663

License Status

EXPIRED

Business

First Name

JOAQUINA

Middle

ELIZABETH

Last Name

VIDES DE MONTOYA

Suffix

Business Name

JOAQUINA ELIZABETH VIDES DE MONTOYA MD

Original Issue Date

06/23/2003

Effective Date

06/23/2003

Expiration Date

06/22/2006

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006