JOSE A FONTANILLA Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036091662

License Status

INACTIVE

Business

First Name

JOSE A

Last Name

FONTANILLA

Business Name

JOSE A FONTANILLA

Original Issue Date

08/22/1995

Effective Date

08/22/1995

Expiration Date

07/31/2002

City

SPRINGDALE

State

Zip

72762

County

ARKANSAS

Ever Disciplined

LastModifiedDate

10/09/2006