GEOFFREY RUSSELL DETOLVE MD - Medical Doctor License in Michigan | # 036054087

GEOFFREY RUSSELL DETOLVE MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054087

License Status

INACTIVE

Business

N

First Name

GEOFFREY RUSSELL

Last Name

DETOLVE

Suffix

MD

Business Name

GEOFFREY RUSSELL DETOLVE MD

Original Issue Date

01/13/1977

Effective Date

01/13/1977

Expiration Date

07/31/1996

State

MI

Ever Disciplined

N

LastModifiedDate

09/20/2006