MICHAEL A FAVILA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070294

License Status

CANCELLED

Business

Title

First Name

MICHAEL

Middle

Last Name

FAVILA

Business Name

MICHAEL A FAVILA DO

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Family Medicine and OMT

Ever Disciplined

LastModifiedDate

05/16/2017