TEQUILLA S STANCIEL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071778

License Status

CANCELLED

Business

Title

First Name

TEQUILLA

Middle

Last Name

STANCIEL

Business Name

TEQUILLA S STANCIEL MD

Original Issue Date

06/24/2018

Effective Date

06/24/2018

Expiration Date

06/23/2021

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/01/2018