LISA M VILLANUEVA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031712

License Status

EXPIRED

Business

First Name

LISA M

Last Name

VILLANUEVA

Business Name

LISA M VILLANUEVA

Original Issue Date

06/07/1994

Effective Date

06/07/1994

Expiration Date

06/30/1997

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006