GOUTAM P SHOME MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036091792

License Status

NOT RENEWED

Business

First Name

GOUTAM P

Last Name

SHOME

Suffix

Business Name

GOUTAM P SHOME MD

Original Issue Date

09/09/1995

Effective Date

09/09/1995

Expiration Date

07/31/1996

City

ANN ARBOR

State

Zip

48103

County

MICHIGAN

Ever Disciplined

LastModifiedDate

09/20/2006