HENRIETTA N TOMBAK MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036078692

License Status

INACTIVE

Business

First Name

HENRIETTA N

Last Name

TOMBAK

Suffix

Business Name

HENRIETTA N TOMBAK MD

Original Issue Date

04/09/1989

Effective Date

04/09/1989

Expiration Date

07/31/1996

City

TOMAH

State

Zip

54660

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006