VIVIAN A ILLERA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016048

License Status

EXPIRED

Business

First Name

VIVIAN A

Last Name

ILLERA

Suffix

Business Name

VIVIAN A ILLERA MD

Original Issue Date

06/15/1983

Effective Date

06/15/1983

Expiration Date

06/19/1985

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006