JOHN BRADLEY STARK MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112556

License Status

INACTIVE

Business

First Name

JOHN

Middle

BRADLEY

Last Name

STARK

Suffix

Business Name

JOHN BRADLEY STARK MD

Original Issue Date

10/20/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

ST AUGUSTINE

State

Zip

32080

Ever Disciplined

LastModifiedDate

04/17/2008