RAFAEL ROBERTO MEDINA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102060

License Status

NOT RENEWED

Business

First Name

RAFAEL

Middle

ROBERTO

Last Name

MEDINA

Suffix

Business Name

RAFAEL ROBERTO MEDINA MD

Original Issue Date

03/02/2000

Effective Date

03/02/2000

Expiration Date

07/31/2002

City

DE PERE

State

Zip

54115

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/09/2006