XELENIA ERLYN DEPENA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067686

License Status

CANCELLED

Business

Title

First Name

XELENIA

Middle

ERLYN

Last Name

DEPENA

Business Name

XELENIA ERLYN DEPENA MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/17/2015