DIVINA G AVERILLA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027130

License Status

EXPIRED

Business

First Name

DIVINA G

Last Name

AVERILLA

Suffix

Business Name

DIVINA G AVERILLA MD

Original Issue Date

06/10/1991

Effective Date

06/10/1991

Expiration Date

06/23/1994

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006