MICHAEL MARTIN REPICE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

CANCELLED

Business

First Name

MICHAEL MARTIN

Last Name

REPICE

Suffix

Business Name

MICHAEL MARTIN REPICE MD

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

COLD SPRING HARBOR

State

Zip

11724

County

NEW YORK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006