NIKKALYNN FOSTER DELAURENTIS DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122214

License Status

INACTIVE

Business

Title

First Name

NIKKALYNN

Middle

FOSTER

Last Name

DELAURENTIS

Business Name

NIKKALYNN FOSTER DELAURENTIS DO

Original Issue Date

11/14/2008

Effective Date

11/14/2008

Expiration Date

07/31/2011

City

ADAMS

State

Zip

37010

Ever Disciplined

LastModifiedDate

04/07/2011