AGUSTIN CARVALLO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036045166

License Status

NOT RENEWED

Business

First Name

AGUSTIN

Last Name

CARVALLO

Suffix

Business Name

AGUSTIN CARVALLO MD

Original Issue Date

02/04/1972

Effective Date

02/04/1972

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60629

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006