JUAN N EVANGELISTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036048546

License Status

NOT RENEWED

Business

First Name

JUAN N

Last Name

EVANGELISTA

Suffix

Business Name

JUAN N EVANGELISTA MD

Original Issue Date

12/18/1973

Effective Date

12/18/1973

City

NICEVILLE

State

Zip

32578

County

FLORIDA

Ever Disciplined

LastModifiedDate

09/20/2006