GAYATHRI N MANICKAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036124126

License Status

NOT RENEWED

Business

Title

First Name

GAYATHRI

Middle

Last Name

MANICKAM

Business Name

GAYATHRI N MANICKAM MD

Original Issue Date

07/29/2009

Effective Date

07/29/2009

Expiration Date

07/31/2011

City

TROY

State

Zip

48083

County

MICHIGAN

Ever Disciplined

LastModifiedDate

11/14/2011