GABRIEL GONZALES PORTILLO - Medical Doctor License in Arizona | # 036089092

GABRIEL GONZALES PORTILLO

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036089092

License Status

NOT RENEWED

Business

N

First Name

GABRIEL

Last Name

GONZALES PORTILLO

Business Name

GABRIEL GONZALES PORTILLO

Original Issue Date

07/21/1994

Effective Date

07/21/1994

Expiration Date

07/31/2002

State

AZ

Ever Disciplined

N

LastModifiedDate

10/09/2006