IAN ANTHONY VILLANUEVA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044772

License Status

EXPIRED

Business

First Name

IAN

Middle

ANTHONY

Last Name

VILLANUEVA

Suffix

Business Name

IAN ANTHONY VILLANUEVA MD

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2007

City

MAYWOOD

State

Zip

60153

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

07/03/2007