JARED DAVID CAPOUYA MD 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

JARED

Middle

DAVID

Last Name

CAPOUYA

Suffix

Business Name

JARED DAVID CAPOUYA MD

Original Issue Date

12/14/2006

Effective Date

12/14/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008