LUIS ZABALA BLANCO JR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054990

License Status

CANCELLED

Business

Title

First Name

LUIS

Middle

ZABALA

Last Name

BLANCO

Suffix

Business Name

LUIS ZABALA BLANCO JR MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

03/31/2011