MATIAS SEBASTIAN LOPEZ CHACON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067485

License Status

EXPIRED

Business

Title

First Name

MATIAS

Middle

SEBASTIAN

Last Name

LOPEZ CHACON

Business Name

MATIAS SEBASTIAN LOPEZ CHACON MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2021

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Neuromuscular Medicine

Ever Disciplined

LastModifiedDate

10/11/2022