MARK RUDOLPH FANTAUZZI
Osteopathic Medicine & Surgery - Osteopathic Physician
Michigan 5101011164 Voluntarily Terminated
This Michigan license was held by MARK RUDOLPH FANTAUZZI. The license is no longer active. It was granted on 10/08/1992 and expired on 12/31/2014
LICENSE DETAILS
- License Number: 5101011164
- Category: Osteopathic Physician
- Status: Voluntarily Terminated
- Date Granted: 10/08/1992 (over 32 years ago)
- Expiry Date: 12/31/2014 (over 10 years ago)