MARCOS ESQUENAZI MODIANO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055937

License Status

CANCELLED

Business

Title

First Name

MARCOS

Middle

ESQUENAZI

Last Name

MODIANO

Business Name

MARCOS ESQUENAZI MODIANO MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60654

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

04/16/2009