IGNACIO CABEZUDO VIDAL Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

CANCELLED

Business

First Name

IGNACIO

Last Name

CABEZUDO VIDAL

Business Name

IGNACIO CABEZUDO VIDAL

Original Issue Date

03/24/1994

Effective Date

03/24/1994

Expiration Date

07/31/2002

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006