KANDAVAR M GOPAL MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036058512

License Status

INACTIVE

Business

First Name

KANDAVAR

Middle

Last Name

GOPAL

Suffix

Business Name

KANDAVAR M GOPAL MD

Original Issue Date

03/22/1979

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

BROOKFIELD

State

Zip

53045

County

WISCONSIN

Ever Disciplined

LastModifiedDate

04/07/2011