ARDELLE BRYNNE AMBROSIO ESTOESTA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125079588

License Status

CANCELLED

Business

Title

First Name

ARDELLE BRYNNE

Middle

AMBROSIO

Last Name

ESTOESTA

Business Name

ARDELLE BRYNNE AMBROSIO ESTOESTA MD

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2025

City

DECATUR

State

Zip

62521

County

MACON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/21/2025