MAE GUTIERREZ MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048380

License Status

CANCELLED

Business

First Name

MAE

Last Name

GUTIERREZ

Suffix

Business Name

MAE GUTIERREZ MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006