MILA CORAZON R BACALLA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

ACTIVE

Business

First Name

MILA CORAZON R

Last Name

BACALLA

Suffix

Business Name

MILA CORAZON R BACALLA MD

Original Issue Date

01/01/1997

Effective Date

06/22/2023

Expiration Date

07/31/2026

City

LINCOLNWOOD

State

Zip

60712

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/22/2023