IRA DE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036079297

License Status

NOT RENEWED

Business

First Name

IRA

Last Name

Suffix

Business Name

IRA DE MD

Original Issue Date

08/08/1989

Effective Date

08/08/1989

Expiration Date

07/31/1996

City

BLOOMFIELD

State

Zip

07003

County

NEW JERSEY

Ever Disciplined

LastModifiedDate

09/20/2006