LUIS G MANRIQUE-TRUJILLO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072840

License Status

CANCELLED

Business

Title

First Name

LUIS

Middle

Last Name

MANRIQUE-TRUJILLO

Business Name

LUIS G MANRIQUE-TRUJILLO MD

Original Issue Date

06/20/2021

Effective Date

06/20/2021

Expiration Date

06/30/2022

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

04/13/2021