MOLLY RENA ZAVALA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062930

License Status

CANCELLED

Business

Title

First Name

MOLLY

Middle

RENA

Last Name

ZAVALA

Business Name

MOLLY RENA ZAVALA MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014