LEE MICHAEL PERIOLAT MD - Medical Doctor License in Indiana | # 036046764

LEE MICHAEL PERIOLAT MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046764

License Status

NOT RENEWED

Business

N

First Name

LEE MICHAEL

Last Name

PERIOLAT

Suffix

MD

Business Name

LEE MICHAEL PERIOLAT MD

Original Issue Date

01/23/1973

Effective Date

01/23/1973

Expiration Date

07/31/1990

State

IN

Ever Disciplined

N

LastModifiedDate

09/20/2006