EDGAR TUGAOEN DE PERALTA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048904

License Status

CANCELLED

Business

First Name

EDGAR

Middle

TUGAOEN

Last Name

DE PERALTA

Suffix

Business Name

EDGAR TUGAOEN DE PERALTA MD

Original Issue Date

08/01/2005

Effective Date

08/01/2005

Expiration Date

07/31/2008

City

SPRINGFIELD

State

Zip

62701

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

09/22/2006