HUMBERTO PORTILLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036047053

License Status

NOT RENEWED

Business

First Name

HUMBERTO

Last Name

PORTILLA

Suffix

Business Name

HUMBERTO PORTILLA MD

Original Issue Date

02/07/1973

Effective Date

02/07/1973

City

E PROVIDENCE

State

County

RHODE ISLAND

Ever Disciplined

LastModifiedDate

09/20/2006