ENRIQUE VIA REQUE MD - Medical Corporation License in Illinois | # 042004580

ENRIQUE VIA REQUE MD

Business Entity

NOT RENEWED

License Type

Medical Corporation

Description

REGISTERED MEDICAL CORPORATION

License Number

042004580

License Status

NOT RENEWED

Business

Y

Business Name

ENRIQUE VIA REQUE MD

Original Issue Date

05/26/1981

Effective Date

05/26/1981

Expiration Date

01/01/1988

State

IL

Ever Disciplined

N

LastModifiedDate

09/26/2006