ESTATE KOKOSADZE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119177

License Status

NOT RENEWED

Business

First Name

ESTATE

Last Name

KOKOSADZE

Suffix

Business Name

ESTATE KOKOSADZE MD

Original Issue Date

08/10/2007

Effective Date

06/27/2011

Expiration Date

07/31/2014

City

RAPID CITY

State

Zip

57701

County

SOUTH DAKOTA

Ever Disciplined

LastModifiedDate

11/17/2014