GUSTAVO VILLATE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036035843

License Status

NOT RENEWED

Business

First Name

GUSTAVO

Last Name

VILLATE

Suffix

Business Name

GUSTAVO VILLATE MD

Original Issue Date

05/04/1959

Effective Date

05/04/1959

Expiration Date

07/31/1996

City

LAKE FOREST

State

Zip

60045

County

LAKE

Ever Disciplined

LastModifiedDate

09/20/2006