JAN MICHAEL DULALAS RACOMA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072201

License Status

EXPIRED

Business

Title

First Name

JAN MICHAEL

Middle

DULALAS

Last Name

RACOMA

Business Name

JAN MICHAEL DULALAS RACOMA MD

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2021

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/11/2022