DAVID T GOUGH MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069644

License Status

INACTIVE

Business

First Name

DAVID T

Last Name

GOUGH

Suffix

Business Name

DAVID T GOUGH MD

Original Issue Date

10/15/1984

Effective Date

10/15/1984

Expiration Date

07/31/1987

City

BOISE

State

Zip

83703

County

IDAHO

Ever Disciplined

LastModifiedDate

09/20/2006