BRIAN DEBELEN VICUNA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112088

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

DEBELEN

Last Name

VICUNA

Business Name

BRIAN DEBELEN VICUNA

Original Issue Date

08/11/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

LAS VEGAS

State

Zip

89145

Ever Disciplined

LastModifiedDate

11/06/2008