LOLITA TINA ONTIVEROS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036144179

License Status

NOT RENEWED

Business

Title

First Name

LOLITA

Middle

TINA

Last Name

ONTIVEROS

Business Name

LOLITA TINA ONTIVEROS MD

Original Issue Date

08/23/2017

Effective Date

08/23/2017

Expiration Date

09/30/2020

City

PALM HARBOR

State

Zip

54683

Ever Disciplined

LastModifiedDate

01/14/2021