SUSANA VILLATE PRIETO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071191

License Status

CANCELLED

Business

Title

First Name

SUSANA

Last Name

VILLATE PRIETO

Business Name

SUSANA VILLATE PRIETO MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/12/2017