KEILA N LOPEZ Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045848

License Status

EXPIRED

Business

First Name

KEILA

Middle

Last Name

LOPEZ

Business Name

KEILA N LOPEZ

Original Issue Date

06/24/2003

Effective Date

06/24/2003

Expiration Date

06/23/2006

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006