MINTESINOT T FITAMO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000593

License Status

CANCELLED

Business

Title

First Name

MINTESINOT

Middle

Last Name

FITAMO

Business Name

MINTESINOT T FITAMO MD

Original Issue Date

04/07/2014

Effective Date

04/07/2014

Expiration Date

10/06/2014

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/13/2015