FERNANDO GUSTAVO DIAZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036049484

License Status

NOT RENEWED

Business

First Name

FERNANDO GUSTAVO

Last Name

DIAZ

Suffix

Business Name

FERNANDO GUSTAVO DIAZ MD

Original Issue Date

08/28/1974

Effective Date

08/28/1974

City

MINNEAPOLIS

State

Zip

55418

County

MINNESOTA

Ever Disciplined

LastModifiedDate

09/20/2006