ERNESTO VIZCARRA ESTOR JR Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049719

License Status

CANCELLED

Business

First Name

ERNESTO

Middle

VIZCARRA

Last Name

ESTOR

Suffix

Business Name

ERNESTO VIZCARRA ESTOR JR

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2008

City

CHICAGO

State

Zip

60660

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006