JESSICA PORTILLO ROMERO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056928

License Status

CANCELLED

Business

Title

First Name

JESSICA

Last Name

PORTILLO ROMERO

Business Name

JESSICA PORTILLO ROMERO MD

Original Issue Date

06/26/2009

Effective Date

06/26/2009

Expiration Date

06/25/2012

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/21/2009