ENRIQUE VIA REQUE MD Medical Corporation License verification

Business Entity

NOT RENEWED

License Type

Medical Corporation

Description

REGISTERED MEDICAL CORPORATION

License Number

042004580

License Status

NOT RENEWED

Business

Business Name

ENRIQUE VIA REQUE MD

Original Issue Date

05/26/1981

Effective Date

05/26/1981

Expiration Date

01/01/1988

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/26/2006