SANTIAGO A ULLOA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

SANTIAGO

Middle

Last Name

ULLOA

Suffix

Business Name

SANTIAGO A ULLOA MD

Original Issue Date

07/20/1998

Effective Date

07/20/1998

Expiration Date

07/31/2008

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008