EUGENE M TANQUILUT DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031178

License Status

EXPIRED

Business

First Name

EUGENE M

Last Name

TANQUILUT

Suffix

Business Name

EUGENE M TANQUILUT DO

Original Issue Date

05/16/1994

Effective Date

05/16/1994

Expiration Date

06/30/1997

City

PEORIA

State

Zip

61603

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006