BLANCA R DAVID MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125025627

License Status

EXPIRED

Business

First Name

BLANCA R

Last Name

DAVID

Suffix

Business Name

BLANCA R DAVID MD

Original Issue Date

06/20/1990

Effective Date

06/20/1990

Expiration Date

06/30/1993

City

DECATUR

State

Zip

62526

County

MACON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006