JUAN C PORTELA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

JUAN

Middle

Last Name

PORTELA

Suffix

Business Name

JUAN C PORTELA MD

Original Issue Date

06/12/2002

Effective Date

06/12/2002

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017