ILUMINADA HOLGAD DAZA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

First Name

ILUMINADA HOLGAD

Last Name

DAZA

Suffix

Business Name

ILUMINADA HOLGAD DAZA MD

Original Issue Date

10/13/1987

Effective Date

10/13/1987

Expiration Date

07/31/2008

City

ORLAND PARK

State

Zip

60462

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011