MARK H GOTFRIED MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036057661

License Status

INACTIVE

Business

First Name

MARK H

Last Name

GOTFRIED

Suffix

Business Name

MARK H GOTFRIED MD

Original Issue Date

09/25/1978

Effective Date

09/25/1978

Expiration Date

07/31/1987

City

PHOENIX

State

Zip

85006

County

ARIZONA

Ever Disciplined

LastModifiedDate

09/20/2006