ANTONIO REPASO BOLINAO JR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047060

License Status

CANCELLED

Business

First Name

ANTONIO

Middle

REPASO

Last Name

BOLINAO

Suffix

JR MD

Business Name

ANTONIO REPASO BOLINAO JR MD

Original Issue Date

07/31/2003

Effective Date

07/31/2003

Expiration Date

07/30/2006

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006