ELANA YAEL POULTER MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119638

License Status

INACTIVE

Business

First Name

ELANA

Middle

YAEL

Last Name

POULTER

Suffix

Business Name

ELANA YAEL POULTER MD

Original Issue Date

11/02/2007

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

BEDFORD

State

Zip

01730

Ever Disciplined

LastModifiedDate

04/07/2011