JOSE LUIS BAEZ-ESCUDERO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

NOT RENEWED

Business

Title

First Name

JOSE

Middle

LUIS

Last Name

BAEZ-ESCUDERO

Business Name

JOSE LUIS BAEZ-ESCUDERO MD

Original Issue Date

03/19/2009

Effective Date

03/19/2009

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011