IRMA ESTACIO MARAVILLA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

ACTIVE

Business

First Name

IRMA ESTACIO

Last Name

MARAVILLA

Suffix

Business Name

IRMA ESTACIO MARAVILLA MD

Original Issue Date

01/01/1997

Effective Date

06/04/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60646

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/04/2023