LARS KEKOA VAN ETTEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036163515

License Status

ACTIVE

Business

Title

First Name

LARS

Middle

KEKOA

Last Name

VAN ETTEN

Business Name

LARS KEKOA VAN ETTEN MD

Original Issue Date

01/30/2023

Effective Date

07/13/2023

Expiration Date

07/31/2026

City

PUEBLO

State

Zip

81005

Ever Disciplined

LastModifiedDate

07/13/2023