MARK RYAN PAPENFUSS DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036125965

License Status

NOT RENEWED

Business

First Name

MARK

Middle

RYAN

Last Name

PAPENFUSS

Suffix

Business Name

MARK RYAN PAPENFUSS DO

Original Issue Date

06/08/2010

Effective Date

09/01/2020

Expiration Date

07/31/2023

City

STAR

State

Zip

83669

County

IDAHO

Ever Disciplined

LastModifiedDate

11/30/2023