LAURIE PENHALL MACDONALD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036107177

License Status

NOT RENEWED

Business

First Name

LAURIE

Middle

PENHALL

Last Name

MACDONALD

Suffix

Business Name

LAURIE PENHALL MACDONALD MD

Original Issue Date

06/11/2002

Effective Date

06/11/2002

Expiration Date

07/31/2005

City

WINSTON-SALEM

State

Zip

27127

County

NORTH CAROLINA

Ever Disciplined

LastModifiedDate

10/09/2006