MARK PASCUAL MONTEFOLKA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043591

License Status

EXPIRED

Business

First Name

MARK

Middle

PASCUAL

Last Name

MONTEFOLKA

Suffix

Business Name

MARK PASCUAL MONTEFOLKA MD

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2004

City

DECATUR

State

Zip

62526

County

MACON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006