JOSUE VILLALTA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036060336

License Status

INACTIVE

Business

First Name

JOSUE

Last Name

VILLALTA

Suffix

Business Name

JOSUE VILLALTA MD

Original Issue Date

05/16/1980

Effective Date

05/16/1980

Expiration Date

07/31/1987

City

INDIANAPOLIS

State

Zip

46250

County

INDIANA

Ever Disciplined

LastModifiedDate

09/20/2006