JOSE A AYALA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050511

License Status

CANCELLED

Business

First Name

JOSE

Middle

Last Name

AYALA

Suffix

Business Name

JOSE A AYALA MD

Original Issue Date

08/16/2005

Effective Date

08/16/2005

Expiration Date

08/15/2008

City

CHICAGO

State

Zip

60639

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006