RALPH DAVID PETTY MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036037863

License Status

INACTIVE

Business

First Name

RALPH DAVID

Last Name

PETTY

Suffix

Business Name

RALPH DAVID PETTY MD

Original Issue Date

08/14/1962

Effective Date

08/14/1962

Expiration Date

07/31/1987

City

SHAWAHO

State

Zip

54166

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006