MARIA ELENA FUENTES MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046489

License Status

CANCELLED

Business

First Name

MARIA

Middle

ELENA

Last Name

FUENTES

Suffix

Business Name

MARIA ELENA FUENTES MD

Original Issue Date

06/15/2003

Effective Date

06/15/2003

Expiration Date

06/14/2006

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006