RICHARD JACOB VANTIENDEREN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001220

License Status

EXPIRED

Business

Title

First Name

RICHARD

Middle

JACOB

Last Name

VANTIENDEREN

Business Name

RICHARD JACOB VANTIENDEREN DO

Original Issue Date

07/02/2018

Effective Date

07/02/2018

Expiration Date

10/01/2018

City

MANHATTAN

State

Zip

66502

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

12/04/2018