ANDRES F MAFLA GRISALES MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048434

License Status

EXPIRED

Business

Title

First Name

ANDRES

Middle

Last Name

MAFLA GRISALES

Business Name

ANDRES F MAFLA GRISALES MD

Original Issue Date

06/24/2004

Effective Date

06/24/2004

Expiration Date

07/31/2007

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

08/29/2007