ENRIQUE PERALTA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112111

License Status

ACTIVE

Business

First Name

ENRIQUE

Last Name

PERALTA

Suffix

Business Name

ENRIQUE PERALTA MD

Original Issue Date

08/13/2004

Effective Date

04/20/2023

Expiration Date

07/31/2026

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

04/20/2023