ROSAURA LICEA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

NOT RENEWED

Business

First Name

ROSAURA

Last Name

LICEA

Business Name

ROSAURA LICEA

Original Issue Date

08/23/1995

Effective Date

06/28/2017

Expiration Date

09/30/2020

City

CICERO

State

Zip

60804

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021