AUGUSTINE L PERROTTA DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036042665

License Status

INACTIVE

Business

First Name

AUGUSTINE L

Last Name

PERROTTA

Suffix

Business Name

AUGUSTINE L PERROTTA DO

Original Issue Date

07/11/1969

Effective Date

07/11/1969

Expiration Date

07/31/2005

City

BLOOMFIELD HILLS

State

Zip

48304

County

MICHIGAN

Ever Disciplined

LastModifiedDate

10/09/2006