JONNY A MACIAS TEJADA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000253

License Status

EXPIRED

Business

First Name

JONNY

Middle

Last Name

MACIAS TEJADA

Suffix

Business Name

JONNY A MACIAS TEJADA MD

Original Issue Date

12/01/2006

Effective Date

12/01/2006

Expiration Date

05/31/2007

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/06/2007