IVAN MANUEL DEQUESADA MD - Medical Doctor License in Georgia | # 036139767

IVAN MANUEL DEQUESADA MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036139767

License Status

NOT RENEWED

Business

N

Title

MD

First Name

IVAN

Middle

MANUEL

Last Name

DEQUESADA

Business Name

IVAN MANUEL DEQUESADA MD

Original Issue Date

02/16/2016

Effective Date

02/16/2016

Expiration Date

07/31/2017

State

GA

Ever Disciplined

N

LastModifiedDate

11/01/2017