LYDIA SIMEONA Q VILLAFUERTE Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

ACTIVE

Business

First Name

LYDIA

Middle

SIMEONA Q

Last Name

VILLAFUERTE

Business Name

LYDIA SIMEONA Q VILLAFUERTE

Original Issue Date

03/13/1995

Effective Date

04/30/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/30/2023