TRAVIS MICHAEL CHURILLA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077588

License Status

CANCELLED

Business

Title

First Name

TRAVIS

Middle

MICHAEL

Last Name

CHURILLA

Business Name

TRAVIS MICHAEL CHURILLA MD

Original Issue Date

06/23/2021

Effective Date

06/23/2021

Expiration Date

06/22/2024

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

04/07/2021