BLAINE MICHAEL HANNAFIN MD - Medical Doctor License in Arizona | # 036122086

BLAINE MICHAEL HANNAFIN MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122086

License Status

INACTIVE

Business

N

Title

MD

First Name

BLAINE

Middle

MICHAEL

Last Name

HANNAFIN

Business Name

BLAINE MICHAEL HANNAFIN MD

Original Issue Date

10/17/2008

Effective Date

10/17/2008

Expiration Date

07/31/2011

State

AZ

Ever Disciplined

N

LastModifiedDate

04/07/2011