LIAWATY HO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112500

License Status

NOT RENEWED

Business

First Name

LIAWATY

Last Name

Suffix

Business Name

LIAWATY HO MD

Original Issue Date

10/08/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

LAS VEGAS

State

Zip

89102

County

CLARK

Ever Disciplined

LastModifiedDate

11/06/2008