TOMAS MAURICIO PRUDENCIO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125085227

License Status

ACTIVE

Business

Title

First Name

TOMAS

Middle

MAURICIO

Last Name

PRUDENCIO

Business Name

TOMAS MAURICIO PRUDENCIO MD

Original Issue Date

06/23/2025

Effective Date

06/23/2025

Expiration Date

06/22/2028

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

04/18/2025