DIEGO JOSE HEREDIA-VINTIMILLA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036130815

License Status

ACTIVE

Business

Title

First Name

DIEGO

Middle

JOSE

Last Name

HEREDIA-VINTIMILLA

Business Name

DIEGO JOSE HEREDIA-VINTIMILLA MD

Original Issue Date

07/11/2012

Effective Date

07/31/2023

Expiration Date

07/31/2026

City

GRANGER

State

Zip

46530

Ever Disciplined

LastModifiedDate

07/31/2023