EDILIA M VIVANCO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125024662

License Status

EXPIRED

Business

First Name

EDILIA M

Last Name

VIVANCO

Business Name

EDILIA M VIVANCO

Original Issue Date

04/24/1990

Effective Date

04/24/1990

Expiration Date

06/24/1993

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006