MARCELO ERNESTO BRITO TELLES Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059019

License Status

EXPIRED

Business

First Name

MARCELO

Middle

ERNESTO

Last Name

BRITO TELLES

Business Name

MARCELO ERNESTO BRITO TELLES

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/13/2015