DIEGO JOSE HEREDIA-VINTIMILLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

Title

First Name

DIEGO

Middle

JOSE

Last Name

HEREDIA-VINTIMILLA

Business Name

DIEGO JOSE HEREDIA-VINTIMILLA MD

Original Issue Date

07/11/2012

Effective Date

04/23/2014

Expiration Date

07/31/2017

City

NORRIDGE

State

Zip

60706

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020