ENRICO TADEO C VILLANUEVA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030993

License Status

EXPIRED

Business

First Name

ENRICO TADEO C

Last Name

VILLANUEVA

Business Name

ENRICO TADEO C VILLANUEVA

Original Issue Date

05/04/1994

Effective Date

05/04/1994

Expiration Date

06/21/1997

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006