JOSE L MEDINA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

JOSE L

Last Name

MEDINA

Suffix

Business Name

JOSE L MEDINA MD

Original Issue Date

01/01/1997

Effective Date

05/20/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60646

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020