KERI ROBERTSON FUENZALIDA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047279

License Status

CANCELLED

Business

First Name

KERI

Middle

ROBERTSON

Last Name

FUENZALIDA

Suffix

Business Name

KERI ROBERTSON FUENZALIDA DO

Original Issue Date

06/21/2004

Effective Date

06/21/2004

Expiration Date

06/30/2007

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006