KRISTIAN R HENRIQUEZ MIRANDONA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063740

License Status

CANCELLED

Business

Title

First Name

KRISTIAN

Middle

Last Name

HENRIQUEZ MIRANDONA

Business Name

KRISTIAN R HENRIQUEZ MIRANDONA MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/21/2016