LUZDIVINA A VINE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061631

License Status

EXPIRED

Business

Title

First Name

LUZDIVINA

Middle

Last Name

VINE

Business Name

LUZDIVINA A VINE MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/04/2015