LUIS CORNELIO DIAZ-GORRICHATEGUI Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034194

License Status

EXPIRED

Business

First Name

LUIS CORNELIO

Last Name

DIAZ-GORRICHATEGUI

Business Name

LUIS CORNELIO DIAZ-GORRICHATEGUI

Original Issue Date

05/08/1996

Effective Date

05/08/1996

Expiration Date

06/30/1999

City

DECATUR

State

Zip

62526

County

MACON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006