MARLITO P FAVILA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

First Name

MARLITO P

Last Name

FAVILA

Suffix

Business Name

MARLITO P FAVILA MD

Original Issue Date

12/28/1994

Effective Date

06/10/2020

Expiration Date

07/31/2023

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023