MARILYN MITTENTHAL DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036074173

License Status

NOT RENEWED

Business

First Name

MARILYN

Last Name

MITTENTHAL

Suffix

Business Name

MARILYN MITTENTHAL DO

Original Issue Date

11/21/1986

Effective Date

11/21/1986

Expiration Date

07/31/1996

City

GRAND RAPIDS

State

Zip

49546

County

MICHIGAN

Ever Disciplined

LastModifiedDate

09/20/2006