JUAN MARTIN VALDIVIA VALDIVID MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046497

License Status

EXPIRED

Business

First Name

JUAN

Middle

MARTIN

Last Name

VALDIVIA VALDIVID

Suffix

Business Name

JUAN MARTIN VALDIVIA VALDIVID MD

Original Issue Date

06/23/2003

Effective Date

06/23/2003

Expiration Date

06/22/2005

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006