BRILLANTE CHAN SANTILLAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

BRILLANTE CHAN

Last Name

SANTILLAN

Suffix

Business Name

BRILLANTE CHAN SANTILLAN MD

Original Issue Date

01/01/1997

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

BENLD

State

Zip

62009

County

MACOUPIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011