RAFAEL M DE LA CRUZ Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108921

License Status

ACTIVE

Business

First Name

RAFAEL

Middle

Last Name

DE LA CRUZ

Business Name

RAFAEL M DE LA CRUZ

Original Issue Date

04/01/2003

Effective Date

07/26/2023

Expiration Date

07/31/2026

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

07/26/2023