ANTONIO MARTIN JIMENEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

First Name

ANTONIO

Middle

MARTIN

Last Name

JIMENEZ

Suffix

Business Name

ANTONIO MARTIN JIMENEZ MD

Original Issue Date

05/19/2009

Effective Date

04/08/2014

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

11/01/2017