CAMIA P ACEVEDO-CUSTODIO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036076225

License Status

NOT RENEWED

Business

First Name

CAMIA P

Last Name

ACEVEDO-CUSTODIO

Suffix

Business Name

CAMIA P ACEVEDO-CUSTODIO MD

Original Issue Date

10/24/1987

Effective Date

05/07/2014

Expiration Date

07/31/2017

City

SAN JOSE

State

Zip

62682

County

MASON

Ever Disciplined

LastModifiedDate

11/01/2017