DAVID CARLO DE FAZIO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036121146

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

CARLO

Last Name

DE FAZIO

Suffix

Business Name

DAVID CARLO DE FAZIO MD

Original Issue Date

06/11/2008

Effective Date

06/11/2008

Expiration Date

07/31/2011

City

IRVING

State

Zip

75062

Ever Disciplined

LastModifiedDate

11/14/2011