GEISEL RAQUEL B COLLAZO GARCIA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058395

License Status

CANCELLED

Business

Title

First Name

GEISEL RAQUEL

Middle

Last Name

COLLAZO GARCIA

Business Name

GEISEL RAQUEL B COLLAZO GARCIA MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2013

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/18/2010