EMMANUEL B FAVILA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036078728

License Status

NOT RENEWED

Business

First Name

EMMANUEL B

Last Name

FAVILA

Suffix

Business Name

EMMANUEL B FAVILA MD

Original Issue Date

04/15/1989

Effective Date

04/15/1989

Expiration Date

07/31/2002

City

TERRE HAUTE

State

Zip

47802

County

INDIANA

Ever Disciplined

LastModifiedDate

10/09/2006