GRACE MARIA THEODORO MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036060778

License Status

INACTIVE

Business

First Name

GRACE MARIA

Last Name

THEODORO

Suffix

Business Name

GRACE MARIA THEODORO MD

Original Issue Date

08/13/1980

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

ST LOUIS

State

Zip

63141

County

MISSOURI

Ever Disciplined

LastModifiedDate

08/25/2015