MIGUEL ENRIQUE MANRIQUE PALAVICCINI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

ACTIVE

Business

Title

First Name

MIGUEL

Middle

ENRIQUE

Last Name

MANRIQUE PALAVICCINI

Business Name

MIGUEL ENRIQUE MANRIQUE PALAVICCINI MD

Original Issue Date

07/09/2025

Effective Date

07/09/2025

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/09/2025