TERESITA DEDIOS AVILA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

First Name

TERESITA DEDIOS

Last Name

AVILA

Suffix

Business Name

TERESITA DEDIOS AVILA MD

Original Issue Date

08/22/1985

Effective Date

06/20/2014

Expiration Date

07/31/2017

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017