RYAN TATE WEST DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125087032

License Status

ACTIVE

Business

Title

First Name

RYAN

Middle

TATE

Last Name

WEST

Business Name

RYAN TATE WEST DO

Original Issue Date

07/01/2025

Effective Date

07/01/2025

Expiration Date

06/30/2028

City

CARBONDALE

State

Zip

62901

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/09/2025