MICHAEL D MENDOZA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

MENDOZA

Suffix

Business Name

MICHAEL D MENDOZA MD

Original Issue Date

08/11/2005

Effective Date

06/26/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60617

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011