DIANA SOFIA VILLACIS NUNEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036158823

License Status

NOT RENEWED

Business

Title

First Name

DIANA

Middle

SOFIA

Last Name

VILLACIS NUNEZ

Business Name

DIANA SOFIA VILLACIS NUNEZ MD

Original Issue Date

11/19/2021

Effective Date

11/19/2021

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023