MARK EVAN DEMUTH DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036110355

License Status

NOT RENEWED

Business

First Name

MARK

Middle

EVAN

Last Name

DEMUTH

Suffix

Business Name

MARK EVAN DEMUTH DO

Original Issue Date

10/23/2003

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

ELIZABETHTOWN

State

Zip

42701

County

KENTUCKY

Ever Disciplined

LastModifiedDate

11/14/2011