PURITA ZABALA VILLANUEVA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

First Name

PURITA ZABALA

Last Name

VILLANUEVA

Suffix

Business Name

PURITA ZABALA VILLANUEVA MD

Original Issue Date

07/21/1983

Effective Date

07/21/1983

Expiration Date

07/31/1984

City

SPRINGFIELD

State

Zip

62708

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006