JESSIE L MABAQUIAO 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

JESSIE L

Last Name

MABAQUIAO

Suffix

Business Name

JESSIE L MABAQUIAO MD

Original Issue Date

06/08/2004

Effective Date

06/16/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II IV

Ever Disciplined

LastModifiedDate

04/05/2020