IVAN MANUEL DEQUESADA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036139767

License Status

NOT RENEWED

Business

Title

First Name

IVAN

Middle

MANUEL

Last Name

DEQUESADA

Business Name

IVAN MANUEL DEQUESADA MD

Original Issue Date

02/16/2016

Effective Date

02/16/2016

Expiration Date

07/31/2017

City

ATLANTA

State

Zip

30317

County

GEORGIA

Ever Disciplined

LastModifiedDate

11/01/2017