MICHAEL JAMES COSTELLO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036139402

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

JAMES

Last Name

COSTELLO

Business Name

MICHAEL JAMES COSTELLO MD

Original Issue Date

11/20/2015

Effective Date

07/17/2017

Expiration Date

09/30/2020

City

PORT ST LUCIE

State

Zip

34986

County

FLORIDA

Ever Disciplined

LastModifiedDate

01/14/2021