J WARREN WILLEY II DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036124405

License Status

NOT RENEWED

Business

Title

First Name

Middle

WARREN

Last Name

WILLEY

Suffix

Business Name

J WARREN WILLEY II DO

Original Issue Date

09/23/2009

Effective Date

08/08/2011

Expiration Date

07/31/2014

City

POCATELLO

State

Zip

83201

County

IDAHO

Ever Disciplined

LastModifiedDate

11/17/2014