DANIEL M STORMONT MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036075615

License Status

INACTIVE

Business

First Name

DANIEL

Middle

Last Name

STORMONT

Suffix

Business Name

DANIEL M STORMONT MD

Original Issue Date

08/15/1987

Effective Date

08/15/1987

Expiration Date

07/31/2005

City

MONROE

State

Zip

53566

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/09/2006