RICARDO HERRARTE CRISOSTOMO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

ACTIVE

Business

Title

First Name

RICARDO

Middle

HERRARTE

Last Name

CRISOSTOMO

Business Name

RICARDO HERRARTE CRISOSTOMO MD

Original Issue Date

04/10/2023

Effective Date

04/10/2023

Expiration Date

07/31/2026

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/10/2023