ENRICO TADEO C VILLANUEVA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

First Name

ENRICO TADEO C

Last Name

VILLANUEVA

Business Name

ENRICO TADEO C VILLANUEVA

Original Issue Date

06/27/1997

Effective Date

06/27/1997

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006