ANITA T AVILA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

ANITA

Middle

Last Name

AVILA

Suffix

Business Name

ANITA T AVILA MD

Original Issue Date

01/01/1997

Effective Date

04/29/2014

Expiration Date

07/31/2017

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017