MICHAEL JED MENCHAVEZ SIAP DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036151426

License Status

ACTIVE

Business

Title

First Name

MICHAEL JED

Middle

MENCHAVEZ

Last Name

SIAP

Business Name

MICHAEL JED MENCHAVEZ SIAP DO

Original Issue Date

12/24/2019

Effective Date

08/01/2023

Expiration Date

07/31/2026

City

LAFAYETTE

State

Zip

47905

Ever Disciplined

LastModifiedDate

08/01/2023