SHANNELLE SUSANNE RICO MD - Medical Doctor License in South Dakota | # 036093151

SHANNELLE SUSANNE RICO MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036093151

License Status

INACTIVE

Business

N

First Name

SHANNELLE

Middle

SUSANNE

Last Name

RICO

Suffix

MD

Business Name

SHANNELLE SUSANNE RICO MD

Original Issue Date

06/08/1996

Effective Date

06/08/1996

Expiration Date

07/31/2002

State

SD

Ever Disciplined

N

LastModifiedDate

01/31/2019