LAURA VILLAVICENCIO BRIZ MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069155

License Status

CANCELLED

Business

Title

First Name

LAURA

Middle

VILLAVICENCIO

Last Name

BRIZ

Business Name

LAURA VILLAVICENCIO BRIZ MD

Original Issue Date

06/24/2019

Effective Date

06/24/2019

Expiration Date

06/23/2020

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

05/22/2019