JARED DAVID CAPOUYA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050596

License Status

CANCELLED

Business

First Name

JARED

Middle

DAVID

Last Name

CAPOUYA

Suffix

Business Name

JARED DAVID CAPOUYA MD

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatric Infectious Diseases

Ever Disciplined

LastModifiedDate

09/22/2006