LISA M VILLANUEVA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

ACTIVE

Business

First Name

LISA M

Last Name

VILLANUEVA

Business Name

LISA M VILLANUEVA

Original Issue Date

07/16/1996

Effective Date

05/19/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/19/2023