MARK AWANTANG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036148056

License Status

NOT RENEWED

Business

Title

First Name

MARK

Last Name

AWANTANG

Business Name

MARK AWANTANG MD

Original Issue Date

01/07/2019

Effective Date

01/07/2019

Expiration Date

09/30/2020

City

PANAMA CITY

State

Zip

32405

Ever Disciplined

LastModifiedDate

01/14/2021