License holder summary

JUAN CARLOS DETATA is a Medical Physician And Surgeon licensed to practice in Pennsylvania. The address on file for JUAN CARLOS DETATA is SAN FRANCISCO CA 94115. This medical practitioner license is not current. The license was granted 01/10/1963 and expired on 12/31/1986.

Department of State

Board of Medicine

JUAN CARLOS DETATA
Medical Physician And Surgeon
License number
MD028453L
Date granted
01/10/1963
Date expires
12/31/1986
Class
Medical Physician And Surgeon
Status
Inactive
Address
SAN FRANCISCO CA 94115
medicinepa.com
ID 37601866
LAST UPDATED 2024-02-17 10:28:06 UTC

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