GLORIA BUENTELLO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

GLORIA

Last Name

BUENTELLO

Business Name

GLORIA BUENTELLO

Original Issue Date

08/12/1981

Effective Date

05/31/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60610

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021