TRAVIS MARK AMENGUAL - Medical Doctor License in Illinois | # 036153670

TRAVIS MARK AMENGUAL

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036153670

License Status

ACTIVE

Business

N

First Name

TRAVIS

Middle

MARK

Last Name

AMENGUAL

Business Name

TRAVIS MARK AMENGUAL

Original Issue Date

07/10/2020

Effective Date

04/06/2023

Expiration Date

07/31/2026

State

IL

Ever Disciplined

N

LastModifiedDate

12/29/2025