JAXEL LOPEZ SEPULVEDA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061967

License Status

CANCELLED

Business

Title

First Name

JAXEL

Last Name

LOPEZ SEPULVEDA

Business Name

JAXEL LOPEZ SEPULVEDA MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014