ANTONIO R WICO JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036047458

License Status

NOT RENEWED

Business

First Name

ANTONIO R

Last Name

WICO JR

Suffix

Business Name

ANTONIO R WICO JR MD

Original Issue Date

06/22/1973

Effective Date

06/22/1973

Expiration Date

07/31/1993

City

PHOENIX

State

Zip

85044

County

ARIZONA

Ever Disciplined

LastModifiedDate

02/06/2007

Case Number

2004002990

Action

Refuse To Renew

Discipline Start Date

06/16/2004

Discipline Reason

Disciplined in Arizona.