MACARIO FABIA LICHAUCO MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036098812

License Status

INACTIVE

Business

First Name

MACARIO

Middle

FABIA

Last Name

LICHAUCO

Suffix

Business Name

MACARIO FABIA LICHAUCO MD

Original Issue Date

08/18/1998

Effective Date

08/18/1998

Expiration Date

07/31/2005

City

SIERRA VISTA

State

Zip

85635

County

MAINE

Ever Disciplined

LastModifiedDate

10/09/2006