VIVIANA SOFIA BARQUET PIZA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075437

License Status

CANCELLED

Business

Title

First Name

VIVIANA

Middle

SOFIA

Last Name

BARQUET PIZA

Business Name

VIVIANA SOFIA BARQUET PIZA MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2023

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

03/24/2020