MARYANN KURUVILLA JACOB MD - Medical Doctor License in Michigan | # 036109150

MARYANN KURUVILLA JACOB MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109150

License Status

NOT RENEWED

Business

N

First Name

MARYANN

Middle

KURUVILLA

Last Name

JACOB

Suffix

MD

Business Name

MARYANN KURUVILLA JACOB MD

Original Issue Date

05/01/2003

Effective Date

05/01/2003

Expiration Date

07/31/2005

State

MI

Ever Disciplined

N

LastModifiedDate

10/09/2006