PHILLIP B STORM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036048994

License Status

NOT RENEWED

Business

First Name

PHILLIP B

Last Name

STORM

Suffix

Business Name

PHILLIP B STORM MD

Original Issue Date

02/20/1974

Effective Date

02/20/1974

Expiration Date

07/01/1976

City

PETOSKEY

State

Zip

49770

County

MICHIGAN

Ever Disciplined

LastModifiedDate

09/19/2014