GREGORY RICHARD MICKLOW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036100064

License Status

NOT RENEWED

Business

First Name

GREGORY

Middle

RICHARD

Last Name

MICKLOW

Suffix

Business Name

GREGORY RICHARD MICKLOW MD

Original Issue Date

04/21/1999

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

DUNEDIN

State

Zip

34698

Ever Disciplined

LastModifiedDate

03/25/2009