VIVIAN A ILLERA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

NOT RENEWED

Business

First Name

VIVIAN A

Last Name

ILLERA

Suffix

Business Name

VIVIAN A ILLERA MD

Original Issue Date

06/25/1986

Effective Date

06/25/1986

Expiration Date

07/31/1987

City

BERWYN

State

Zip

60402

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006