CARLOS MIGUEL AVILA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065885

License Status

CANCELLED

Business

Title

First Name

CARLOS

Middle

MIGUEL

Last Name

AVILA

Business Name

CARLOS MIGUEL AVILA MD

Original Issue Date

06/26/2014

Effective Date

06/26/2014

Expiration Date

06/25/2017

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/04/2014