JOSE RAFAEL BALSA GUERRERO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073408

License Status

CANCELLED

Business

Title

First Name

JOSE

Middle

RAFAEL

Last Name

BALSA GUERRERO

Business Name

JOSE RAFAEL BALSA GUERRERO MD

Original Issue Date

07/15/2018

Effective Date

07/15/2018

Expiration Date

07/14/2021

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/09/2018