MARCIA L PETRICK MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036092854

License Status

INACTIVE

Business

First Name

MARCIA

Middle

Last Name

PETRICK

Suffix

Business Name

MARCIA L PETRICK MD

Original Issue Date

05/24/1996

Effective Date

04/21/2014

Expiration Date

07/31/2017

City

VALPARAISO

State

Zip

46383

County

INDIANA

Ever Disciplined

LastModifiedDate

04/12/2017