JESUS RENE DADIVAS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056219

License Status

CANCELLED

Business

Title

First Name

JESUS

Middle

RENE

Last Name

DADIVAS

Business Name

JESUS RENE DADIVAS MD

Original Issue Date

06/25/2009

Effective Date

06/25/2009

Expiration Date

06/24/2012

City

NILES

State

Zip

60714

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/20/2009