LEOPOLDO M BASILICO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058563

License Status

EXPIRED

Business

Title

First Name

LEOPOLDO

Middle

Last Name

BASILICO

Business Name

LEOPOLDO M BASILICO MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2013

City

EL DORADO HILLS

State

Zip

95762

County

CALIFORNIA

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

10/07/2013