ISMARY CHACON
Physician Assistant at 159 Ave, Hollywood, FL

License number
Florida 9107555
Issued Date
Sep 25, 2013
Effective Date
Sep 25, 2013
Expiration Date
Jan 31, 2018
Category
Health Care
Type
Physician Assistant
Address
Address 2
1558 NW 159Th Ave, Hollywood, FL 33028
3663 S Miami Ave, Miami, FL 33133
Phone
(786) 650-9655
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

Organization information

See more information about ISMARY CHACON at bizstanding.com

ISMARY CHACON PA

1558 NW 159 Ave, Hollywood, FL 33028

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Oct 27, 2004
Inactive since:
Sep 26, 2008
State ID:
P04000147928
Business type:
Florida Profit Corporation
President:
Ismary Chacon President, inactive, 1558 NW 159 Ave, Hollywood, FL 33028 (Physical)
Agent:
Chacon, Ismary,1558 NW 159 Ave, Hollywood, FL 33028 (Physical)
EIN:
20-1808095

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