SERGIO E LEAL Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

CANCELLED

Business

First Name

SERGIO

Middle

Last Name

LEAL

Business Name

SERGIO E LEAL

Original Issue Date

05/23/2005

Effective Date

05/23/2005

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008