JUSTIN P COLLINGHAM Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036110574

License Status

INACTIVE

Business

First Name

JUSTIN

Middle

Last Name

COLLINGHAM

Business Name

JUSTIN P COLLINGHAM

Original Issue Date

12/11/2003

Effective Date

12/11/2003

Expiration Date

07/31/2005

City

MENLO PARK

State

Zip

94025

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

10/09/2006