TYLER JONATHAN SURMA MD Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096003128

License Status

NOT RENEWED

Business

Title

First Name

TYLER

Middle

JONATHAN

Last Name

SURMA

Business Name

TYLER JONATHAN SURMA MD

Original Issue Date

07/14/2011

Effective Date

05/15/2014

Expiration Date

05/31/2016

City

SOUTHFIELD

State

Zip

48076

Ever Disciplined

LastModifiedDate

07/11/2016