MICHAEL GONZAGA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046140

License Status

INACTIVE

Business

First Name

MICHAEL

Last Name

GONZAGA

Suffix

Business Name

MICHAEL GONZAGA MD

Original Issue Date

08/17/1972

Effective Date

08/17/1972

Expiration Date

07/31/1987

City

EAU CLAIRE

State

Zip

54701

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006