JASON R MATTINGLY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036105501

License Status

NOT RENEWED

Business

First Name

JASON

Middle

Last Name

MATTINGLY

Suffix

Business Name

JASON R MATTINGLY MD

Original Issue Date

08/29/2001

Effective Date

08/29/2001

Expiration Date

07/31/2002

City

PEORIA

State

Zip

61602

County

PEORIA

Ever Disciplined

LastModifiedDate

10/09/2006