GUILLERMO J TELLEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036083687

License Status

NOT RENEWED

Business

First Name

GUILLERMO J

Last Name

TELLEZ

Suffix

Business Name

GUILLERMO J TELLEZ MD

Original Issue Date

11/04/1991

Effective Date

11/04/1991

Expiration Date

07/31/1999

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

09/20/2006