MOLLY MAXINE DIAZ MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063627

License Status

CANCELLED

Business

Title

First Name

MOLLY

Middle

MAXINE

Last Name

DIAZ

Business Name

MOLLY MAXINE DIAZ MD

Original Issue Date

06/24/2013

Effective Date

06/24/2013

Expiration Date

06/23/2016

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

03/24/2014