HENRY EDWARD MATTIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036061332

License Status

NOT RENEWED

Business

First Name

HENRY EDWARD

Last Name

MATTIS

Suffix

Business Name

HENRY EDWARD MATTIS MD

Original Issue Date

12/01/1980

Effective Date

04/25/2014

Expiration Date

07/31/2017

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

11/01/2017