IVAN JAVIER GAMBOA VELEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

Title

First Name

IVAN

Middle

JAVIER

Last Name

GAMBOA VELEZ

Business Name

IVAN JAVIER GAMBOA VELEZ MD

Original Issue Date

08/26/2014

Effective Date

08/26/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020