ANDREA IRENE GAULT DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036153850

License Status

NOT RENEWED

Business

Title

First Name

ANDREA

Middle

IRENE

Last Name

GAULT

Business Name

ANDREA IRENE GAULT DO

Original Issue Date

07/27/2020

Effective Date

07/27/2020

Expiration Date

07/31/2023

City

BALTIMORE

State

Zip

21230

Ever Disciplined

LastModifiedDate

11/30/2023