GUILLERMO J TELLEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

GUILLERMO J

Last Name

TELLEZ

Suffix

Business Name

GUILLERMO J TELLEZ MD

Original Issue Date

01/23/1992

Effective Date

01/23/1992

Expiration Date

07/31/1999

City

MATTOON

State

Zip

61938

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006