Louisiana
Board of Licensing
Council Benny DeAntorrio
Medical
License number
POLY.000163
Date expires
05/31/2015
Class
Medical
Status
Active
Address
5001 Highway 190 E Service Rd., Covington, LA 70433-4930
louisianalicensing.com
ID 22011146
LAST UPDATED 2026-03-10 06:32:07 UTC
LAST UPDATED 2026-03-10 06:32:07 UTC