JACK S HAVDALA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036085154

License Status

INACTIVE

Business

First Name

JACK S

Last Name

HAVDALA

Suffix

Business Name

JACK S HAVDALA MD

Original Issue Date

08/17/1992

Effective Date

08/17/1992

Expiration Date

07/31/2005

City

JONESBORO

State

Zip

72401

County

ARKANSAS

Ever Disciplined

LastModifiedDate

10/09/2006