ANNA-MARIA ALICIA DE COSTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036144310

License Status

NOT RENEWED

Business

Title

First Name

ANNA-MARIA

Middle

ALICIA

Last Name

DE COSTA

Business Name

ANNA-MARIA ALICIA DE COSTA MD

Original Issue Date

09/12/2017

Effective Date

09/12/2017

Expiration Date

09/30/2020

City

MADISON

State

Zip

53705

County

WISCONSIN

Ever Disciplined

LastModifiedDate

01/14/2021