MICHAEL T MODIC MD - Medical Doctor License in Ohio | # 036110221

MICHAEL T MODIC MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036110221

License Status

INACTIVE

Business

N

Title

MD

First Name

MICHAEL

Middle

T

Last Name

MODIC

Business Name

MICHAEL T MODIC MD

Original Issue Date

10/02/2003

Effective Date

10/02/2003

Expiration Date

07/31/2005

State

OH

Ever Disciplined

N

LastModifiedDate

01/02/2007