GUILLERMO MORA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056538

License Status

CANCELLED

Business

Title

First Name

GUILLERMO

Last Name

MORA

Business Name

GUILLERMO MORA MD

Original Issue Date

06/25/2009

Effective Date

06/25/2009

Expiration Date

06/24/2012

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/04/2009