GUSTAVO VILLATE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

NOT RENEWED

Business

First Name

GUSTAVO

Last Name

VILLATE

Suffix

Business Name

GUSTAVO VILLATE MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1996

City

LAKE FOREST

State

Zip

60045

County

LAKE

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

09/26/2006