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DHMH : cdssearch: M07923

CDSPERMIT

M07923

APPLICANT_NAME

A EARL VIVINO

APPLICANT_STATUS

CLOSED

CLASSIFICATION

PRACTITIONER

ADRESS

10317 HARP RD

CITY

WALKERSVILLE

COUNTY

 

ZIP

21793

STATE

MD

ADDRESS2

 

PROFESSION

MD

LICENSE_ISSUEDDATE

7/1/1995 12:00 AM

LICENSE_EXPDATE

6/30/1997 12:00 AM

CURR_CERTIFICATION

Y

Attachments

Created at 11/21/2013 11:55 AM by System Account
Last modified at 11/21/2013 11:55 AM by System Account