STUART EDWARD MIRVIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036144333

License Status

NOT RENEWED

Business

Title

First Name

STUART

Middle

EDWARD

Last Name

MIRVIS

Business Name

STUART EDWARD MIRVIS MD

Original Issue Date

09/15/2017

Effective Date

09/15/2017

Expiration Date

09/30/2020

City

EDEN PRAIRIE

State

Zip

55344

County

MINNESOTA

Ever Disciplined

LastModifiedDate

01/14/2021