KEILA N LOPEZ Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

KEILA

Middle

Last Name

LOPEZ

Business Name

KEILA N LOPEZ

Original Issue Date

05/09/2006

Effective Date

05/09/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008