IVAN JAVIER GAMBOA VELEZ MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059415

License Status

CANCELLED

Business

Title

First Name

IVAN

Middle

JAVIER

Last Name

GAMBOA VELEZ

Business Name

IVAN JAVIER GAMBOA VELEZ MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014