SANTIAGO A ULLOA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037014

License Status

EXPIRED

Business

First Name

SANTIAGO

Middle

Last Name

ULLOA

Suffix

Business Name

SANTIAGO A ULLOA MD

Original Issue Date

06/30/1997

Effective Date

06/30/1997

Expiration Date

06/30/1998

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Colon & Rectal Surgery

Ever Disciplined

LastModifiedDate

09/22/2006