IVAN DIAZ MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111497

License Status

INACTIVE

Business

First Name

IVAN

Last Name

DIAZ

Suffix

Business Name

IVAN DIAZ MD

Original Issue Date

05/27/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

LAKELAND

State

Zip

33812

Ever Disciplined

LastModifiedDate

04/17/2008