JASON A PETRILLA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036124676

License Status

INACTIVE

Business

First Name

JASON

Middle

Last Name

PETRILLA

Suffix

Business Name

JASON A PETRILLA MD

Original Issue Date

11/30/2009

Effective Date

11/30/2009

Expiration Date

07/31/2011

City

BROOKLINE

State

Zip

02446

County

MASSACHUSETTS

Ever Disciplined

LastModifiedDate

04/07/2011