ANTHONY PAUL DIBIASE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036106765

License Status

NOT RENEWED

Business

First Name

ANTHONY

Middle

PAUL

Last Name

DIBIASE

Business Name

ANTHONY PAUL DIBIASE

Original Issue Date

04/12/2002

Effective Date

07/26/2011

Expiration Date

07/31/2014

City

WAYNE

State

Zip

07470

County

NEW JERSEY

Ever Disciplined

LastModifiedDate

11/17/2014