License holder summary

JOSE RAUL VILLAVICENCIO is a Medical Physician And Surgeon licensed to practice in Pennsylvania. The address on file for JOSE RAUL VILLAVICENCIO is COLUMBUS OH 43232. This medical practitioner license is not current. The license was granted 07/01/1994 and expired on 12/31/1996.

Department of State

Board of Medicine

JOSE RAUL VILLAVICENCIO
Medical Physician And Surgeon
License number
MD052604L
Date granted
07/01/1994
Date expires
12/31/1996
Class
Medical Physician And Surgeon
Status
Revoked
Address
COLUMBUS OH 43232
medicinepa.com
ID 37685693
LAST UPDATED 2024-04-21 16:41:31 UTC

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