SIMON JOSEPH PULLUKAT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036050897

License Status

NOT RENEWED

Business

First Name

SIMON JOSEPH

Last Name

PULLUKAT

Suffix

Business Name

SIMON JOSEPH PULLUKAT MD

Original Issue Date

03/21/1975

Effective Date

03/21/1975

Expiration Date

07/31/1987

City

WEST BLOOMFIELD

State

Zip

48033

County

MICHIGAN

Ever Disciplined

LastModifiedDate

09/20/2006