AMY PHYLLIS GOLDBERG MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036103462

License Status

INACTIVE

Business

First Name

AMY

Middle

PHYLLIS

Last Name

GOLDBERG

Suffix

Business Name

AMY PHYLLIS GOLDBERG MD

Original Issue Date

09/13/2000

Effective Date

09/13/2000

Expiration Date

07/31/2002

City

PROVIDENCE

State

Zip

02906

County

RHODE ISLAND

Ever Disciplined

LastModifiedDate

10/09/2006