ALICIA MANDUJANO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050138

License Status

CANCELLED

Business

First Name

ALICIA

Last Name

MANDUJANO

Suffix

Business Name

ALICIA MANDUJANO MD

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2008

City

CLARENCE CENTER

State

Zip

14032

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006