MAURICIO E PALENCIA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036103391

License Status

NOT RENEWED

Business

First Name

MAURICIO

Middle

Last Name

PALENCIA

Business Name

MAURICIO E PALENCIA

Original Issue Date

09/05/2000

Effective Date

09/05/2000

Expiration Date

07/31/2002

City

BAYSIDE

State

Zip

53217

Ever Disciplined

LastModifiedDate

05/23/2011