RAFAEL L GALLARDO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036068281

License Status

NOT RENEWED

Business

First Name

RAFAEL

Middle

Last Name

GALLARDO

Suffix

Business Name

RAFAEL L GALLARDO MD

Original Issue Date

03/02/1984

Effective Date

06/05/2017

Expiration Date

09/30/2020

City

TERRE HAUTE

State

Zip

47807

County

INDIANA

Ever Disciplined

LastModifiedDate

01/14/2021