HERALDO TAVELLA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032466

License Status

EXPIRED

Business

First Name

HERALDO

Last Name

TAVELLA

Business Name

HERALDO TAVELLA

Original Issue Date

05/05/1995

Effective Date

05/05/1995

Expiration Date

06/30/1996

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006