MYRA FRANCISCO VICENIO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047551

License Status

EXPIRED

Business

First Name

MYRA

Middle

FRANCISCO

Last Name

VICENIO

Suffix

Business Name

MYRA FRANCISCO VICENIO MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

BARTLETT

State

Zip

60103

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/03/2007