HORMUZDIYAR HENRY DASENBROCK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036146741

License Status

NOT RENEWED

Business

Title

First Name

HORMUZDIYAR

Middle

HENRY

Last Name

DASENBROCK

Business Name

HORMUZDIYAR HENRY DASENBROCK MD

Original Issue Date

07/02/2018

Effective Date

07/02/2018

Expiration Date

09/30/2020

City

BOSTON

State

Zip

02120

County

MASSACHUSETTS

Ever Disciplined

LastModifiedDate

01/14/2021