EMMANUEL A FAVILA DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059180

License Status

EXPIRED

Business

Title

First Name

EMMANUEL

Middle

Last Name

FAVILA

Business Name

EMMANUEL A FAVILA DO

Original Issue Date

06/22/2011

Effective Date

06/22/2011

Expiration Date

06/21/2014

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/13/2015