ROGER A VILLALBA 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

First Name

ROGER A

Last Name

VILLALBA

Suffix

Business Name

ROGER A VILLALBA MD

Original Issue Date

01/01/1997

Effective Date

05/25/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60622

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014