WILLIAM FREDERICK BEVILACQUA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036135322

License Status

NOT RENEWED

Business

Title

First Name

WILLIAM

Middle

FREDERICK

Last Name

BEVILACQUA

Business Name

WILLIAM FREDERICK BEVILACQUA MD

Original Issue Date

05/13/2014

Effective Date

05/13/2014

Expiration Date

07/31/2017

City

AMHERST

State

Zip

14228

County

NEW YORK

Ever Disciplined

LastModifiedDate

11/01/2017