JONATHAN ROMAN ENRIQUEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

First Name

JONATHAN

Middle

ROMAN

Last Name

ENRIQUEZ

Suffix

Business Name

JONATHAN ROMAN ENRIQUEZ MD

Original Issue Date

04/23/2008

Effective Date

04/23/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011