NICOLAS MANUEL LOPEZ HISIJOS DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064868

License Status

CANCELLED

Business

Title

First Name

NICOLAS

Middle

MANUEL

Last Name

LOPEZ HISIJOS

Business Name

NICOLAS MANUEL LOPEZ HISIJOS DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2020

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Hematopathology

Ever Disciplined

LastModifiedDate

05/06/2019