AGUSTINUS WILARAS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036070917

License Status

NOT RENEWED

Business

First Name

AGUSTINUS

Last Name

WILARAS

Suffix

Business Name

AGUSTINUS WILARAS MD

Original Issue Date

06/17/1985

Effective Date

06/17/1985

Expiration Date

07/31/1987

City

BUFFALO

State

Zip

14201

County

NEW YORK

Ever Disciplined

LastModifiedDate

09/20/2006