MONIQUE RAE ICE Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111437

License Status

INACTIVE

Business

First Name

MONIQUE

Middle

RAE

Last Name

ICE

Business Name

MONIQUE RAE ICE

Original Issue Date

05/24/2004

Effective Date

05/24/2004

Expiration Date

07/31/2005

City

HOWELL

State

Zip

48843

County

OHIO

Ever Disciplined

LastModifiedDate

10/09/2006