LAWRENCE R DULTZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036094739

License Status

NOT RENEWED

Business

First Name

LAWRENCE R

Last Name

DULTZ

Suffix

Business Name

LAWRENCE R DULTZ MD

Original Issue Date

02/03/1997

Effective Date

06/17/2011

Expiration Date

07/31/2014

City

TERRE HAUTE

State

Zip

47807

County

INDIANA

Ever Disciplined

LastModifiedDate

11/17/2014