MICHAEL DAVID PETRUCCI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129964

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

DAVID

Last Name

PETRUCCI

Business Name

MICHAEL DAVID PETRUCCI MD

Original Issue Date

04/05/2012

Effective Date

04/05/2012

Expiration Date

07/31/2014

City

COLORADO SPRINGS

State

Zip

80920

Ever Disciplined

LastModifiedDate

11/17/2014