AUGUSTO ALBERTO MIRAVALLE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036118267

License Status

ACTIVE

Business

First Name

AUGUSTO

Middle

ALBERTO

Last Name

MIRAVALLE

Suffix

Business Name

AUGUSTO ALBERTO MIRAVALLE MD

Original Issue Date

04/27/2007

Effective Date

07/25/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

07/29/2023