TERENCE LOU DALLO AGUSTIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036124749

License Status

NOT RENEWED

Business

First Name

TERENCE LOU

Middle

DALLO

Last Name

AGUSTIN

Suffix

Business Name

TERENCE LOU DALLO AGUSTIN MD

Original Issue Date

12/17/2009

Effective Date

06/09/2014

Expiration Date

07/31/2017

City

HENDERSON

State

Zip

89074

County

NEVADA

Ever Disciplined

LastModifiedDate

11/01/2017