MICHAEL A DE LA TORRE Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

ACTIVE

Business

First Name

MICHAEL A

Last Name

DE LA TORRE

Business Name

MICHAEL A DE LA TORRE

Original Issue Date

07/02/1996

Effective Date

06/10/2023

Expiration Date

07/31/2026

City

ZION

State

Zip

60099

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/10/2023