RAQUEL GOMEZ-MORA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

CANCELLED

Business

First Name

RAQUEL

Last Name

GOMEZ-MORA

Suffix

Business Name

RAQUEL GOMEZ-MORA MD

Original Issue Date

10/13/1998

Effective Date

10/13/1998

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008