ANGELITA V FONTANILLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036126513

License Status

NOT RENEWED

Business

Title

First Name

ANGELITA

Middle

Last Name

FONTANILLA

Business Name

ANGELITA V FONTANILLA MD

Original Issue Date

08/18/2010

Effective Date

07/08/2011

Expiration Date

07/31/2014

City

WATSEKA

State

Zip

60970

County

IROQUOIS

Ever Disciplined

LastModifiedDate

11/17/2014