JUAN PABLO TRIVELLA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000999

License Status

CANCELLED

Business

Title

First Name

JUAN

Middle

PABLO

Last Name

TRIVELLA

Business Name

JUAN PABLO TRIVELLA MD

Original Issue Date

07/28/2014

Effective Date

07/28/2014

Expiration Date

08/27/2014

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Gastroenterology

Ever Disciplined

LastModifiedDate

03/13/2015