| | Physician Last Name: | Avian Medical |
| | Physician First Name: | P.C. |
| | Physician Middle Name: | |
| | Address: | c/o Alexander G. Bateman, Esq.
East Tower 15th Floor
1425 Texcorp Plaza
Uniondale, New York 11556-1425 |
| | License Number: | 214667 |
| | License Type: | |
| | Year of Birth: |
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| | Effective Date: | 10/11/2007 |
| | Action Description for DOH Webpage: | Annulment of certificate of incorporation. |
| | Misconduct Description for DOH Webpage: | The corporation admitted to the charge of failing to comply with New York State Business Law Section 1503. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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