EDWARD ROBERT VILLELLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036134438

License Status

NOT RENEWED

Business

Title

First Name

EDWARD

Middle

ROBERT

Last Name

VILLELLA

Business Name

EDWARD ROBERT VILLELLA MD

Original Issue Date

01/16/2014

Effective Date

05/19/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017