EDWARD CHARLES VILLA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061573

License Status

CANCELLED

Business

Title

First Name

EDWARD

Middle

CHARLES

Last Name

VILLA

Business Name

EDWARD CHARLES VILLA MD

Original Issue Date

06/22/2012

Effective Date

06/22/2012

Expiration Date

06/21/2015

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014