REBECCA M MARTIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036064905

License Status

NOT RENEWED

Business

First Name

REBECCA

Middle

Last Name

MARTIN

Suffix

Business Name

REBECCA M MARTIN MD

Original Issue Date

07/30/1982

Effective Date

07/30/1982

Expiration Date

07/31/1990

City

FORT WAYNE

State

Zip

46814

Ever Disciplined

LastModifiedDate

01/05/2007