Information as of 10/21/2018

Last Updated by Licensee on 05/22/2017

Edwin Laserna Fuentes - DO Full and Unrestricted
License#: 
Issue Date: 
9701749
02/01/2013
License Status: 
Expire Date:
Inactive  
07/31/2018  
 Public Action: Yes
 See: Actions-Adverse & Administrative Tab
Licensee General Information
Active License
Reason CodeLicense NumberSubcategoryIssue DateExpire Date
 9701749 11/22/1997 
Inactive License
Reason CodeLicense NumberSubcategoryIssue DateExpire Date
Failed to Register9701749 02/01/201307/31/2018
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None Reported