ELBA MARITZA VILLAVICENCIO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

ACTIVE

Business

Title

First Name

ELBA

Middle

MARITZA

Last Name

VILLAVICENCIO

Business Name

ELBA MARITZA VILLAVICENCIO MD

Original Issue Date

10/03/2012

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60660

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023