FRED RAY PORTNEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036032900

License Status

NOT RENEWED

Business

First Name

FRED RAY

Last Name

PORTNEY

Suffix

Business Name

FRED RAY PORTNEY MD

Original Issue Date

09/20/1954

Effective Date

09/20/1954

City

MUNSTER

State

Zip

46321

County

INDIANA

Ever Disciplined

LastModifiedDate

09/20/2006