GEISEL RAQUEL B COLLAZO GARCIA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

ACTIVE

Business

Title

First Name

GEISEL RAQUEL

Middle

Last Name

COLLAZO GARCIA

Business Name

GEISEL RAQUEL B COLLAZO GARCIA MD

Original Issue Date

09/13/2012

Effective Date

06/12/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60613

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/12/2023