ETHAN MALCOLM BRAUNSTEIN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036044244

License Status

INACTIVE

Business

First Name

ETHAN MALCOLM

Last Name

BRAUNSTEIN

Suffix

Business Name

ETHAN MALCOLM BRAUNSTEIN MD

Original Issue Date

06/01/1971

Effective Date

06/01/1971

Expiration Date

07/31/2002

City

FLAGSTAFF

State

Zip

86001

County

ARIZONA

Ever Disciplined

LastModifiedDate

10/09/2006