MARK NOEL VILLANUEVA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053417

License Status

EXPIRED

Business

First Name

MARK

Middle

NOEL

Last Name

VILLANUEVA

Suffix

Business Name

MARK NOEL VILLANUEVA MD

Original Issue Date

06/22/2007

Effective Date

06/22/2007

Expiration Date

06/21/2010

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/24/2010