ANDREW MARCOS I ALTIVEROS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054836

License Status

CANCELLED

Business

Title

First Name

ANDREW MARCOS

Middle

Last Name

ALTIVEROS

Business Name

ANDREW MARCOS I ALTIVEROS MD

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

02/09/2011