EVELENA PATRICE ONTIVEROS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036143984

License Status

ACTIVE

Business

Title

First Name

EVELENA

Middle

PATRICE

Last Name

ONTIVEROS

Business Name

EVELENA PATRICE ONTIVEROS MD

Original Issue Date

07/31/2017

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

04/13/2023