GABRIEL STEFANO GONZALES-PORTILLO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125082850

License Status

ACTIVE

Business

Title

First Name

GABRIEL

Middle

STEFANO

Last Name

GONZALES-PORTILLO

Business Name

GABRIEL STEFANO GONZALES-PORTILLO MD

Original Issue Date

06/24/2023

Effective Date

06/24/2023

Expiration Date

06/23/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Neurosurgery Fellowship

Ever Disciplined

LastModifiedDate

04/20/2023