GARY MARK AMUNDSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129119

License Status

NOT RENEWED

Business

Title

First Name

GARY

Middle

MARK

Last Name

AMUNDSON

Business Name

GARY MARK AMUNDSON MD

Original Issue Date

10/20/2011

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

SOUTH PASADENA

State

Zip

91030

Ever Disciplined

LastModifiedDate

01/14/2021