JOSE RAUL VILLAVICENCIO
Medical Physician And Surgeon
Pennsylvania MD052604L Revoked
This Pennsylvania license was held by JOSE RAUL VILLAVICENCIO. The license is no longer active. It was granted on 07/01/1994 and expired on 12/31/1996
LICENSE DETAILS
- License Number: MD052604L
- Category: Medical Physician and Surgeon
- Status: Revoked
- Date Granted: 07/01/1994 (about 32 years ago)
- Expiry Date: 12/31/1996 (over 29 years ago)
LOCATIONS
A Address
COLUMBUS OH 43232