RICHARD JACOB VANTIENDEREN DO - Medical Doctor License in Kansas | # 130001220

RICHARD JACOB VANTIENDEREN DO

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001220

License Status

EXPIRED

Business

N

Title

DO

First Name

RICHARD

Middle

JACOB

Last Name

VANTIENDEREN

Business Name

RICHARD JACOB VANTIENDEREN DO

Original Issue Date

07/02/2018

Effective Date

07/02/2018

Expiration Date

10/01/2018

State

KS

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

N

LastModifiedDate

12/04/2018