TAYLOR MATTHEW ORTIZ MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047766

License Status

EXPIRED

Business

First Name

TAYLOR

Middle

MATTHEW

Last Name

ORTIZ

Suffix

Business Name

TAYLOR MATTHEW ORTIZ MD

Original Issue Date

06/21/2004

Effective Date

06/21/2004

Expiration Date

06/20/2007

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/03/2007