ANTHONY AMBAL DE LA CRUZ MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052942

License Status

EXPIRED

Business

First Name

ANTHONY

Middle

AMBAL

Last Name

DE LA CRUZ

Suffix

Business Name

ANTHONY AMBAL DE LA CRUZ MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2011

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

07/19/2011