DIANE CLARY JENSEN Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036126986

License Status

INACTIVE

Business

First Name

DIANE

Middle

CLARY

Last Name

JENSEN

Business Name

DIANE CLARY JENSEN

Original Issue Date

12/16/2010

Effective Date

07/21/2011

Expiration Date

07/31/2014

City

MARIETTA

State

Zip

30067

County

GEORGIA

Ever Disciplined

LastModifiedDate

04/08/2014