LYDIA SIMEONA Q VILLAFUERTE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125028789

License Status

EXPIRED

Business

First Name

LYDIA

Middle

SIMEONA Q

Last Name

VILLAFUERTE

Business Name

LYDIA SIMEONA Q VILLAFUERTE

Original Issue Date

06/19/1992

Effective Date

06/19/1992

Expiration Date

06/30/1995

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006