AGUSTIN CARVALLO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

AGUSTIN

Last Name

CARVALLO

Suffix

Business Name

AGUSTIN CARVALLO MD

Original Issue Date

06/23/1982

Effective Date

06/23/1982

Expiration Date

07/31/1999

City

OAK LAWN

State

Zip

60453

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006