ENRICO TADEO C VILLANUEVA Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036093797

License Status

INACTIVE

Business

First Name

ENRICO TADEO C

Last Name

VILLANUEVA

Business Name

ENRICO TADEO C VILLANUEVA

Original Issue Date

07/25/1996

Effective Date

07/25/1996

Expiration Date

07/31/1999

City

GAITHERSBURG

State

Zip

20877

County

MARYLAND

Ever Disciplined

LastModifiedDate

09/20/2006