MABODAWILAGE G HEMATILLAKE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036096093

License Status

NOT RENEWED

Business

First Name

MABODAWILAGE G

Last Name

HEMATILLAKE

Suffix

Business Name

MABODAWILAGE G HEMATILLAKE MD

Original Issue Date

07/17/1997

Effective Date

07/17/1997

Expiration Date

07/31/2002

City

CLOVIS

State

Zip

93611

Ever Disciplined

LastModifiedDate

08/07/2023