BRUCE ALFRED ST AMOUR DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111848

License Status

NOT RENEWED

Business

First Name

BRUCE

Middle

ALFRED

Last Name

ST AMOUR

Suffix

Business Name

BRUCE ALFRED ST AMOUR DO

Original Issue Date

07/13/2004

Effective Date

07/13/2004

Expiration Date

07/31/2005

City

SALEM

State

Zip

24153

Ever Disciplined

LastModifiedDate

04/26/2012