SUSAN AUDREY KOSLOW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036092459

License Status

NOT RENEWED

Business

First Name

SUSAN AUDREY

Last Name

KOSLOW

Suffix

Business Name

SUSAN AUDREY KOSLOW MD

Original Issue Date

02/27/1996

Effective Date

04/18/2014

Expiration Date

07/31/2017

City

TERRE HAUTE

State

Zip

47802

County

INDIANA

Ever Disciplined

LastModifiedDate

11/01/2017