TESALIA R RENTERIA DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067595

License Status

EXPIRED

Business

Title

First Name

TESALIA

Middle

Last Name

RENTERIA

Business Name

TESALIA R RENTERIA DO

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/25/2018