GASTON MARCOS PONTE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052601

License Status

CANCELLED

Business

First Name

GASTON

Middle

MARCOS

Last Name

PONTE

Suffix

Business Name

GASTON MARCOS PONTE MD

Original Issue Date

06/24/2007

Effective Date

06/24/2007

Expiration Date

06/23/2010

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/17/2007