BRIAN P DICKOVER MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036110780

License Status

INACTIVE

Business

First Name

BRIAN

Middle

Last Name

DICKOVER

Suffix

Business Name

BRIAN P DICKOVER MD

Original Issue Date

02/03/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

MICHIGAN CITY

State

Zip

46360

Ever Disciplined

LastModifiedDate

12/02/2014