MAYRA GONZALEZ MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059468

License Status

CANCELLED

Business

Title

First Name

MAYRA

Last Name

GONZALEZ

Business Name

MAYRA GONZALEZ MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

CHICAGO

State

Zip

60638

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014