DIEGO JESUS PEREZ Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

NOT RENEWED

Business

First Name

DIEGO

Middle

JESUS

Last Name

PEREZ

Business Name

DIEGO JESUS PEREZ

Original Issue Date

02/09/2011

Effective Date

02/09/2011

Expiration Date

07/31/2011

City

FOREST PARK

State

Zip

60130

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011