CARLOS E VILLAVICENCIO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037750

License Status

EXPIRED

Business

First Name

CARLOS

Middle

Last Name

VILLAVICENCIO

Business Name

CARLOS E VILLAVICENCIO

Original Issue Date

06/15/1998

Effective Date

06/15/1998

Expiration Date

06/14/2001

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006