JONATHAN L LARSEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

CANCELLED

Business

First Name

JONATHAN L

Last Name

LARSEN

Suffix

Business Name

JONATHAN L LARSEN MD

Original Issue Date

08/24/1995

Effective Date

08/24/1995

Expiration Date

07/31/2002

City

PHOENIX

State

Zip

85013

County

ARIZONA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006