MARCIAL Q FAVILA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036063164

License Status

NOT RENEWED

Business

First Name

MARCIAL Q

Last Name

FAVILA

Suffix

Business Name

MARCIAL Q FAVILA MD

Original Issue Date

09/10/1981

Effective Date

05/19/2020

Expiration Date

07/31/2023

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023