MARK MILLER SHULDBERG DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036137906

License Status

INACTIVE

Business

Title

First Name

MARK

Middle

MILLER

Last Name

SHULDBERG

Business Name

MARK MILLER SHULDBERG DO

Original Issue Date

05/01/2015

Effective Date

05/30/2017

Expiration Date

09/30/2020

City

ALAMOSA

State

Zip

81101

Ever Disciplined

LastModifiedDate

04/05/2020