JOSE FERNANDO CHAVEZ MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057156

License Status

CANCELLED

Business

Title

First Name

JOSE

Middle

FERNANDO

Last Name

CHAVEZ

Business Name

JOSE FERNANDO CHAVEZ MD

Original Issue Date

06/26/2009

Effective Date

06/26/2009

Expiration Date

06/25/2012

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/26/2009