GUADALUPE NIETO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

NOT RENEWED

Business

First Name

GUADALUPE

Last Name

NIETO

Business Name

GUADALUPE NIETO

Original Issue Date

06/17/1991

Effective Date

06/17/1991

Expiration Date

07/31/1993

City

LOCKPORT

State

Zip

60441

County

WILL

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

09/26/2006