ROBERTO CARLOS B COLLANTES MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052068

License Status

EXPIRED

Business

First Name

ROBERTO CARLOS

Middle

Last Name

COLLANTES

Suffix

Business Name

ROBERTO CARLOS B COLLANTES MD

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/15/2009