HELEN VIDALI FOUNTAIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036158430

License Status

NOT RENEWED

Business

Title

First Name

HELEN

Middle

VIDALI

Last Name

FOUNTAIN

Business Name

HELEN VIDALI FOUNTAIN MD

Original Issue Date

10/02/2021

Effective Date

10/02/2021

Expiration Date

07/31/2023

City

CLARKSBURG

State

Zip

20871

County

MONTGOMERY

Ever Disciplined

LastModifiedDate

11/30/2023