ALFONSO JAVIER MEDINA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

NOT RENEWED

Business

First Name

ALFONSO JAVIER

Last Name

MEDINA

Suffix

Business Name

ALFONSO JAVIER MEDINA MD

Original Issue Date

01/01/1997

Effective Date

04/14/2011

Expiration Date

07/31/2014

City

HOMEWOOD

State

Zip

60430

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014