ROGER A VILLALBA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036044665

License Status

NOT RENEWED

Business

First Name

ROGER A

Last Name

VILLALBA

Suffix

Business Name

ROGER A VILLALBA MD

Original Issue Date

08/09/1971

Effective Date

05/25/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014