EVAN J ANDERSON Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036105919

License Status

INACTIVE

Business

First Name

EVAN

Middle

Last Name

ANDERSON

Business Name

EVAN J ANDERSON

Original Issue Date

11/29/2001

Effective Date

04/18/2011

Expiration Date

07/31/2014

City

DECATUR

State

Zip

30030

County

DEKALB

Ever Disciplined

LastModifiedDate

04/09/2014