CARLOS ALFONSO QUILALA SANTOS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046675

License Status

EXPIRED

Business

First Name

CARLOS ALFONSO

Middle

QUILALA

Last Name

SANTOS

Suffix

Business Name

CARLOS ALFONSO QUILALA SANTOS MD

Original Issue Date

07/01/2003

Effective Date

07/01/2003

Expiration Date

06/30/2006

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006