VIVIAN CASTILLO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

CANCELLED

Business

First Name

VIVIAN

Last Name

CASTILLO

Suffix

Business Name

VIVIAN CASTILLO MD

Original Issue Date

09/14/1999

Effective Date

09/14/1999

Expiration Date

07/31/2002

City

GRAND TOWER

State

Zip

62942

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006