EDMUNDO JOSE MANRIQUE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058630

License Status

EXPIRED

Business

Title

First Name

EDMUNDO

Middle

JOSE

Last Name

MANRIQUE

Business Name

EDMUNDO JOSE MANRIQUE MD

Original Issue Date

06/25/2010

Effective Date

06/25/2010

Expiration Date

06/24/2013

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/07/2013