TATYANA VLADIMIROVNA PETROSOVA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036107203

License Status

INACTIVE

Business

First Name

TATYANA

Middle

VLADIMIROVNA

Last Name

PETROSOVA

Suffix

Business Name

TATYANA VLADIMIROVNA PETROSOVA MD

Original Issue Date

06/13/2002

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

EAST ALTON

State

Zip

62024

County

MADISON

Ever Disciplined

LastModifiedDate

04/07/2011