DIEGO COLE VILLACIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

ACTIVE

Business

Title

First Name

DIEGO

Middle

COLE

Last Name

VILLACIS

Business Name

DIEGO COLE VILLACIS MD

Original Issue Date

12/28/2015

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

LAKE BLUFF

State

Zip

60044

County

NEW YORK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023