OLIVER MODEQUILLO OLEA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114777

License Status

NOT RENEWED

Business

First Name

OLIVER

Middle

MODEQUILLO

Last Name

OLEA

Business Name

OLIVER MODEQUILLO OLEA

Original Issue Date

10/20/2005

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

GENEVA

State

Zip

60134

County

DEKALB

Ever Disciplined

LastModifiedDate

01/14/2021