FALLON ANDREA MATTIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036144488

License Status

ACTIVE

Business

Title

First Name

FALLON

Middle

ANDREA

Last Name

MATTIS

Business Name

FALLON ANDREA MATTIS MD

Original Issue Date

10/12/2017

Effective Date

06/22/2023

Expiration Date

07/31/2026

City

MIDDLETOWN

State

Zip

19709

Ever Disciplined

LastModifiedDate

07/31/2024