JUAQUITO MARIO JORGE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058982

License Status

CANCELLED

Business

Title

First Name

JUAQUITO

Middle

MARIO

Last Name

JORGE

Business Name

JUAQUITO MARIO JORGE MD

Original Issue Date

10/12/2011

Effective Date

10/12/2011

Expiration Date

10/11/2012

City

EVANS

State

Zip

30809

Specialty/Qualifier

Burn Fellowship

Ever Disciplined

LastModifiedDate

10/12/2011