JUANITO S BARTOLOME JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

Title

First Name

JUANITO S

Last Name

BARTOLOME

Suffix

Business Name

JUANITO S BARTOLOME JR MD

Original Issue Date

01/01/1997

Effective Date

05/01/2014

Expiration Date

07/31/2017

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017