KIRK PATRICK MAXINO UY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055747

License Status

CANCELLED

Business

Title

First Name

KIRK PATRICK

Middle

MAXINO

Last Name

Business Name

KIRK PATRICK MAXINO UY MD

Original Issue Date

06/15/2009

Effective Date

06/15/2009

Expiration Date

06/14/2012

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/27/2009