JOHANNA C FUENTES-VALDES MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108457

License Status

INACTIVE

Business

Title

First Name

JOHANNA

Middle

Last Name

FUENTES-VALDES

Business Name

JOHANNA C FUENTES-VALDES MD

Original Issue Date

01/17/2003

Effective Date

05/18/2011

Expiration Date

07/31/2014

City

MIDVALE

State

Zip

84047

Ever Disciplined

LastModifiedDate

04/27/2015